早期鼻咽NK/T细胞淋巴瘤不同亚型间临床特征、疗效、总生存率和无进展生存率差异比较

Comparison of Clinical Characteristics,Curative Efficacy,Total Survival Rate and Progression Free Survival Rate in Different Subtypes of Early Nasopharyngeal NK/T Cell Lymphoma

目的:比较早期鼻咽NK/T细胞淋巴瘤不同亚型间临床特征、疗效、总生存率和无进展生存率的差异。方法:收集本院收治的83例早期鼻咽NK/T细胞淋巴瘤患者的临床资料进行回顾性分析。将83例患者分为2组:NK细胞淋巴瘤59例为A组,细胞毒性T细胞表型24例为B组。比较2组患者临床特征、疗效、生存预后的差异。结果:A组患者病灶局部侵犯、骨质破坏的发生率均明显低于B组(P<0.05);A组患者治疗总有效率(91.53%)较B组(58.33%)显著升高;A组5年总生存率(59.32%)和无进展生存率(45.76%)较B组(29.17%、16.67%)均显著升高(Log-rank=4.22、4.41,P<0.05)。伴有噬血综合征是影响鼻咽NK/T细胞淋巴瘤患者总生存的危险因素(OR=3.03,95%CI:1.53-6.00,P<0.01);性别、肿瘤亚型及累及淋巴结均是影响患者无进展生存的相关因素(OR=2.01、1.12、3.68,95%CI:1.07-3.77、1.05-1.19、1.63~8.27,均P<0.05)。结论:在早期鼻咽NK/T细胞淋巴瘤患者中,T细胞淋巴瘤较NK细胞淋巴瘤更易出现局部侵犯,且近、远期疗效、生存及预后较差,故在临床中应积极采用放化疗综合治疗的方式以改善患者预后效果。

Objective： To compare the clinical characteristics,clinical efficacy,overall survival rate and progressionfree survival rate between different subtypes of early nasopharyngeal NK/T cell lymphoma. Methods： The clinical data of 83 patients with early nasopharyngeal NK/T cell lymphoma in our hospital were retrospectively analyzed,the 83 patients were divided into 2 group： 59 cases of NK cell lymphoma as group A,24 cases of cytotoxic T cell phenotype as group B. The differences of clinical characteristics,clinical efficacy and survival prognosis were compared between the 2 groups. Results： The incidence rate of lesion and bone destruction in the group A was significantly lower than those in the group B（ P〈0. 05）. The total effective rate in the group A was（ 91. 53%） significantly higher than that in group B（ 58. 33%）（ P〈0. 05）,and overall survival rate（ 59. 32%） and progression-free survival rate（ 45. 76%） of 5 years in the groupA were significantly higher than those in the group B（ 29. 17%,16. 67%）（ Log-rank = 4. 22,4. 41,P〈0. 05）. Hemophagocytic syndrome was a risk factor for overall survival in patients with nasopharyngeal NK/T cell lymphoma（ OR = 3. 03,95%CI： 1. 53-6. 00,P〈0. 01）,and sex,tumor subtype and involvement of lymph node were the related factors affecting progression-free survival（ OR = 2. 01,1. 12,3. 68,95% CI： 1. 07 ～ 3. 77,1. 05-1. 19,1. 63-8. 27,P〈0. 05）. Conclusion： In the patients with early nasopharyngeal NK/T cell lymphoma,T cell lymphoma as compared with NK cell lymphoma is more prone to local invasion with poor clinical efficacy,survival and prognosis,therefore,chemotherapy methods should be actively adopted to improve prognosis of patients in clinic.