原发皮肤淋巴瘤患者的临床特征和预后因素分析

Clinical Features and Prognostic Factors of Patients with Primary Cutaneous Lymphoma

目的:回顾性分析原发皮肤淋巴瘤患者的临床特征,并分析影响患者预后的因素。方法:回顾性分析新疆和田地区人民医院、长治医学院附属和济医院、解放军总医院第五医学中心2013年1月至2021年6月收治的22例原发皮肤淋巴瘤患者的临床资料。结果:经计算,原发皮肤T、NK/T细胞淋巴瘤患者发病率约91.9/10万,原发皮肤B细胞淋巴瘤约14.5/10万。年龄≥65岁患者的总生存期(OS)与低于65岁患者相比明显缩短(P<0.05);β_(2)-微球蛋白升高患者的OS及PFS均较短(均P<0.05);初治后达完全/部分缓解的患者较疾病稳定或进展患者具有更长的OS(P<0.05)。起源于T、NK/T细胞的不同病理类型患者的OS及PFS具有差异,蕈样肉芽肿患者的OS及PFS均长于其他病理类型患者(均P<0.05);另外,分期也可能影响患者的PFS(P=0.056)。结论:患者年龄、分期、β_(2)-微球蛋白水平、病理类型、治疗后缓解情况对患者预后判断具有临床应用价值。

Objective:To retrospectively analyze the clinical characteristics and prognostic factors of patients with primary cutaneous lymphoma.Methods:The clinical data of 22 patients with primary cutaneous lymphoma admitted to Xinjiang Hotan District People′s Hospital,Heji Hospital affiliated to Changzhi Medical College and the Fifth Medical Center of PLA General Hospital from January 2013 to June 2021 were retrospectively analyzed.Results:The incidence of primary cutaneous T cell and NK/T cell lymphoma was about 91.9/100000,and the incidence of primary cutaneous B cell lymphoma was about 14.5/100000.The overall survival(OS)of patients aged≥65 years was significantly shorter than that of patients younger than 65 years(P<0.05).Patients with elevatedβ2-microglobulin(β2-MG)had shorter OS and progression-free survival(PFS)(both P<0.05).Patients who achieved complete/partial response after initial treatment had longer OS than those with stable or progressive disease(P<0.05).There were significant differences in OS and PFS among patients with different pathological types of primary cutaneous lymphoma that originated from T and NK/T cells,the OS and PFS of patients with mycosis fungoides were longer than those of patients with other pathological types(P<0.05).In addition,disease stage might also affect the PFS of the patients(P=0.056).Conclusion:The age,disease stage,β2-MG level,pathological type and remission state after treatment of the patients were related to the clinical prognosis.