23例睾丸原发性淋巴瘤的临床与病理分析

Clinical and pathological features of 23 patients with primary lymphoma of the testis

目的 研究睾丸原发性淋巴瘤的临床和病理特点 ,探讨最佳的治疗方式。方法 回顾性分析 2 3例睾丸原发性淋巴瘤的临床病理特点、治疗方法及疗效 ,并进行随访。以Kaplan Meier法进行生存分析。结果 2 3例患者主要临床症状为睾丸无痛性肿大。ⅠE 期病例 18例 ,占 78.3%。病理类型以B细胞来源者为主 ,多数为中度恶性淋巴瘤。全部患者均行睾丸切除术 ,术后接受化疗和(或 )放疗 ,中位生存期 4 2个月 ,中位无病生存期 19个月 ;1,3,5年生存率分别为 10 0 .0 %、5 9.8%和36 .5 % ,无病生存率分别为 6 6 .7%、4 2 .3%和 36 .3%。结论 睾丸原发性淋巴瘤应采取综合治疗 ,术后全身化疗不宜少于 6周期 ,局部放疗有利于减少复发。

Objective To study the clinical and pathological features of primary lymphoma of the testis and try to find out the rational treatment modality. Methods Retrospective and follow-up analysis was conducted in 23 patients with primary lymphoma of the testis. Survival analysis was performed by Kaplan-Meier process. Results The primary clinical symptom was painless tumefaction. 78.3% lesions were Stage I_E on diagnosis. Most of them were intermediate grade B cell lymphoma. All patients received orchiectomy followed by chemotherapy and some followed by radiotherapy. The median survival time was 42 months. The overall survival rates at 1,3 and 5 years were 100.0%, 59.8% and 36.5%, respectively. The disease-free survival rates at 1,3 and 5 years were 66.7 %,42.3% and 36.3%,respectively. Conclusion Primary lymphoma of the testis is preferably treated by multi-modality treatment. More than 6 cycles of chemotherapy is rational after orchiectomy. Regional radiotherapy tends to reduce the local relapse.