原发中枢神经系统淋巴瘤患者临床特征和疗效分析

Clinical Characteristics and Outcome of Patients with Primary Central Nervous System Lymphoma

目的探讨原发性中枢神经系统淋巴瘤(primary central nervous system lymphoma,PCNSL)患者的临床特征、病理情况和预后因素.方法回顾性分析2011年-2018年诊断为PCNSL的15例患者,患者分别接受了手术、化疗、全脑放疗(WBRT)等综合治疗.结果15例患者的中位年龄为71岁(范围35~88岁).CD10,Bcl6,MUM1,Bcl2和MYC的蛋白表达分别占0%,57.1%,57.1%,100%和33.3%,有1例生发中心B细胞(GCB)和2例双重表达(MYC+/Bcl2+)淋巴瘤.12例患者为多发性脑病变.分别有7例,4例和3例患者接受了一线WBRT,二线WBRT和手术后巩固WBRT的治疗.中位随访时间为46.0个月,中位生存时间40.0个月,2年生存率为53.3%.与OS相关的因素是WBRT参与的时机(P=0.013).结论影响PCNSL治疗结果的因素是治疗方案.

Objective To explore the clinical characteristics,pathological features and prognostic factors of primary central nervous system lymphoma(PCNSL)patients.Methods A retrospective study of 15 patients diagnosed with PCNSL from 2011 to 2018 was conducted.15 patients were treated with either surgery,chemotherapy,whole brain radiotherapy(WBRT).Results There were 15 patients with a median age of 71 years(range 35-88 years).Protein expression of CD10,Bcl6,MUMI,Bcl2 and MYC were found in 0%,57.1%,57.1%,100%and 33.3%,respectively.Germinal center B cell(GCB)and double-expressor(MYC+/Bc12+)lymphomas were found in 1 and 2 patients,respectively.Multiple brain lesions were seen in 12 patients.First line therapy with WBRT,and second line therapy with W BRT,surgery followed with WBRT were given to 7,4 and 3 patients,respectively.Median follow-up time was 46 months,median overall survival(OS)time was 40 months,and a 2-year OS was 53.3%.Features associated with a prolonged OS were management of WBRT(P=0.013).Conclusion The factors afecting treatment outcomes in PCNSL was treatment regimen.