头颈部恶性淋巴瘤139例临床分析

Malignant lymphoma of head and neck:an analysis of 139 cases

目的 :探讨头颈部恶性淋巴瘤 (ML)临床特点。方法 :回顾分析 1 39例 ML 患者临床资料 ,并进行长期随访。结果 :1 39例 ML 患者中 ,霍奇金病 (HD) 1 1例 ,非霍奇金淋巴瘤 (NHL) 1 2 8例 ;HD平均年龄 4 1 .8岁 ,NHL 5 0 .0岁 ;HD均有淋巴结肿大 ,而 NHL72 .7%有淋巴结肿大 ;HD2 7.3%有结外累及 ,NHL 75 .8%有结外累及 ;HD、NHL 分别有 4 5 .5 %、37.5 %出现全身症状 ;治疗上则以 CHOP及改良 CHOP方案化疗为主。平均随访 2 3.4个月 ,死亡 1 2例 ,3年生存率为 5 5 .6 %。结论 :头颈部 ML 以 NHL 多见 ,且发病年龄偏晚。首侵颈淋巴结者易确诊 。

Objective:To study the clinical characteristics of malignant lymphomas of the head and neck.Methods:The clinical data of 139 patients with malignant lymphomas of the head and neck were retrogradely analyzed,and the long term follow up was carried out.Results:Among all the cases there were 128 non Hodgkin's lymphoma(NHL) and 11 Hodgkin's disease(HD). The average ages of patients with HD and NHL were 41.8 and 50.0 years old respectively.There were lymphadenopathy in all patients with HD and 72.7% of those with NHL. Extranodal involvement occurred in 27.3% HD patients and 75.8% NHL patients; general symptoms appeared in 45.5% HD patients and 37.5% NHL patients. Most patients received chemotherapy of CHOP and improved CHOP scheme.The average follow up time was 23.4 months. Twelve patients died and the 3 year survival rate was 55.6%.Conclusion:In our group, the patients present an older age and NHL is more common than HD.The cases with cervical lymphadenopathy are easy to be diagnosed,and the clinical stage classification is useful for the prognosis.