艾滋病相关淋巴瘤的增强CT表现与化疗效果影响因素分析

Enhanced CT findings of AIDS-related lymphoma and analysis of influence factors of its chemotherapy effect

目的:探讨艾滋病相关淋巴瘤(ARL)的增强CT表现,分析可能影响其化疗效果的因素。方法:搜集经病理证实且行CT平扫及增强扫描的ARL患者51例,回顾性分析51例患者的病灶位置、大小、密度、强化、坏死等CT表现及病理类型、CD4+T淋巴细胞计数、CD4+/CD8+T淋巴细胞比值,分析影响化疗效果的可能因素。结果:ARL患者的CD4+T淋巴细胞计数为(213.53±127.147)个/UL,临床症状以肿块为主,淋巴结内及淋巴结外病变累及组织或器官较广泛。增强扫描主要表现为边界不清38例(74.51%)、密度不均匀35例(68.63%)、中度强化42例(82.35%)及病灶融合38例(74.51%)。ARL对化疗敏感,化疗效果与民族、性别、年龄、合并症、治疗方案、密度、强化特点、是否融合、是否钙化、是否发热、坏死分布、病变最大面积、CD4+T淋巴细胞计数及CD4+/CD8+比值无明显相关性(P值均>0.05),但边界的清晰或模糊与化疗效果具有相关性,边界模糊者的化疗效果优于边界清晰者(Fisher精确检验,P=0.036)。结论:ARL淋巴结内及淋巴结外病变累及组织或器官较广泛,CT增强扫描主要表现为边界不清、密度不均匀、中度强化及病灶融合,ARL对化疗敏感,边界清晰或模糊与化疗效果具有相关性。

Objective:To investigate the enhanced CT findings of AIDS-related lymphoma(ARL)and analyze the factors that may influence its chemotherapy effect.Methods:A total of 51 patients with ARL who were pathologically confirmed and underwent plain and enhanced CT scanning were collected.The CT findings including the location,size,density,enhancement and necrosis of the lesions,pathological types,CD4+T lymphocyte counts and CD4+/CD8+T lymphocyte ratio of 51 patients were retrospectively analyzed,and the possible factors affecting the effect of chemotherapy were analyzed.Results:The CD4+T lymphocyte count in ARL patients was(213.53±127.147)cells/UL.The main clinical symptoms were found mass,with extensive involvement of tissues or organs in and out of lymph nodes.Enhanced scan showed unclear boundary in 38 cases(74.51%),heterogeneous density in 35 cases(68.63%),moderate enhancement in 42 cases(82.35%)and lesion fusion in 38 cases(74.51%).ARL was sensitive to chemotherapy,and the chemotherapy effect was not significantly correlated with ethnicity,gender,age,complications,treatment regimen,density,enhancement characteristics,fusion,calcification,fever,necrosis distribution,maximum lesion area,CD4+T lymphocyte count and CD4+/CD8+ratio(P>0.05);however,the clear or blurred boundary was correlated with the chemotherapy effect,and the chemotherapy effect was better in patients with blurred boundary than that in those with clear boundary(Fisher's exact test,P=0.036).Conclusion:Intralymphatic and extralymphatic lesions of ARL have extensive involvement of tissues or organs,mainly manifested as unclear boundary,heterogeneous density,moderate enhancement and lesion fusion.ARL is sensitive to chemotherapy,and clear or blurred boundary is correlated with the effect of chemotherapy.