15例原发喉NK／T细胞淋巴瘤临床特征及预后分析

Clinical features and prognosis analysis of 15 cases of extra-nodal nasal-type natural killer/T-cell lymphoma originated from the larynx

目的 分析原发喉的结外鼻型NK/T细胞淋巴瘤的临床特征及预后。方法 回顾性分析15例原发喉的结外鼻型NK/T细胞淋巴瘤患者的临床资料,利用Kaplan-Meier方法计算其总生存（OS）及疾病无进展生存（PFS）,利用单因素分析比较不同临床因素对预后的影响。结果 全组15例患者中,男性13例,中位发病年龄为40岁。8例患者的病变局限在喉内,仅4例存在颈部淋巴结受侵。Ann Abor分期Ⅰ期11例,Ⅱ期3例,Ⅲ期1例。全组患者的中位OS为28.0个月,5年OS为32.0%;中位PFS为24.7个月,5年PFS为33.3%。14例Ⅰ/Ⅱ期患者中,接受放化疗综合治疗的预后显著优于单纯放疗及单纯化疗组（中位OS：37.2 ∶11.2 ∶3.7个月,P=0.004）。结论 原发于喉的结外鼻型NK/T细胞淋巴瘤非常罕见,中年男性为主,一般情况较好,早期病变为多,预后较差。放化疗综合治疗的疗效似乎优于单纯放疗或化疗。

Objective To analyze the clinical features and prognosis of extra-nodal nasal NK/T cell lymphoma originated from the larynx. Methods Clinical data of 15 cases of extra-nodal nasal NK/T-cell lymphoma originated from the larynx were retrospectively analyzed. The overall survival （OS） and progression-free survival （PFS） were calculated by Kaplan-Meier survival analysis. The effect of different clinical factors on the clinical prognosis was assessed by univariate analysis. Results Among 15 patients,13 cases were male and 2 female. The median age of onset was 40 years. In 8 cases,the lesions were confined to the larynx,and only 4 cases suffered from cervical lymph node involvement. According to Ann Abor staging,11 cases were classified as grade I,3 as grade Ⅱ and 1 as grade Ⅲ.The median OS was 28.0 months and the 5-year OS was 32.0%.The median PFS was 24.7 months and the 5-year PFS was 33.3%.Among 14 patients with stage Ⅰ/Ⅱ,the clinical prognosis of patients receiving combined chemo-radiotherapy was significantly better than those of their counterparts undergoing radiotherapy or chemotherapy alone （median OS：37.2 vs.11.2 vs.3.7 months,P=0.004）. Conclusion Extra-nodal nasal NK/T cell lymphoma originated from the larynx is extremely rare,predominantly in middle-aged male patients. The general condition is relatively favorable. Patients present with multiple lesions in the early stage and relatively poor prognosis. The clinical efficacy of chemotherapy combined with radiotherapy is probably higher compared with that of radiotherapy or chemotherapy alone.