Non-Hodgkin's lymphoma involving chronic difficult-to-heal wounds:A case report

BACKGROUND Non-Hodgkin's lymphoma(NHL)is a malignant tumor that originates from the lymphoid tissues and can potentially affect numerous organs within the body.Among these,the skin stands out as one of the primary sites affected by NHL,often presenting with multiple extra-nodal manifestations.In this report,we present an unusual case of NHL involving chronic wounds in the lower extremities that were difficult to heal.The scars were successfully treated using radiotherapy in combination with extended excision debridement and peroneal artery perforator flap grafting,resulting in satisfactory outcomes.CASE SUMMARY A 19-year-old male patient presented with ulceration of the skin on the left calf near the ankle accompanied by purulent discharge.Subsequent pathologic biopsy confirmed a diagnosis of NHL(extranodal NK/T-cell lymphoma,nasal type).Initial treatment comprised local radiotherapy and wound care;however,the wound exhibited prolonged non-healing.Consequently,the patient underwent a series of interventions including radiotherapy,wound enlargement excision debridement,and peroneal artery perforator flap grafting.Ultimately,successful healing was achieved with favorable postoperative outcomes characterized by good texture of the flap without any signs of rupture or infection.CONCLUSION The combination of radiotherapy,wound enlargement excision debridement,and peroneal artery perforator flap grafting may present a favorable treatment modality for chronic non-healing lower leg wounds resulting from NHL.

Autologous peripheral blood stem cell mobilization following dose-adjusted cyclophosphamide, doxorubicin, vincristine and prednisolone chemotherapy alone or in combination with rituximab in treating high-risk non-Hodgkin's lymphoma

Background: The regimen of cyclophosphamide, doxorubicin, vincristine, and prednisolone(CHOP) is an eicient treatment of non-Hodgkin's lymphoma(NHL). This study aimed to assess the eicacy and toxicity of dose-adjusted CHOP alone or in combination with rituximab(R-CHOP) by examining the stem cell mobilization in NHL patients. Factors afecting the collection of CD34+ cells were also explored.Methods: Our retrospective study included 39 patients eligible for autologous stem cell transplantation: 14 patients who expressed CD20 and were inancially eligible received R-CHOP for autologous peripheral blood stem cell(APBSC) mobilization; the remaining 25 patients received CHOP.Results: The median CD34+ cell yield was 7.01 × 106 cells/kg body weight(range 1.49–28.39 × 106 cells/kg body weight), with only two patients failing to meet the target CD34+ cell harvest of ber of apheresis procedures per patient was 1(range 1–3). The≥2.0 APBS× 106 cells/kg body weight. The median numC mobilization yield of the CHOP group appeared to be higher than that of the R-CHOP group(P response(CR) rate in = 0.005), whereas the success rate was similar between groups. R-CHOP elevated the completeB cell lymphoma patients as compared with CHOP(P = 0.01). No signiicant diferences in toxicity or engraftment were observed between the two groups.Conclusion: The present study demonstrated that dose-adjusted CHOP chemotherapy efectively mobilized APBSCs in NHL patients and that the addition of rituximab to dose-adjusted CHOP chemotherapy elevated the CR rate for patients with B-cell lymphoma.

Hepatitis C virus and non-Hodgkin's lymphomas:Metaanalysisof epidemiology data and therapy options

Hepatitis C virus(HCV) is a global health problem affecting a large fraction of the world's population: This virus is able to determine both hepatic and extrahepatic diseases. Mixed cryoglobulinemia, a B-cell "benign" lymphoproliferative disorders, represents the most closely related as well as the most investigated HCVrelated extrahepatic disorder. Since this virus is able to determine extrahepatic [non-Hodgkin's lymphoma(NHL)] as well as hepatic malignancies(hepatocellular carcinoma), HCV has been included among human cancer viruses. The most common histological types of HCV-associated NHL are the marginal zone, the lymphoplasmacytic and diffuse large cell lymphomas. The role of the HCV in the pathogenesis of the B-cell lymphoproliferative disorders is confirmed also by the responsiveness of the NHL to antiviral therapy. The purpose of this review is to provide an overview of the recent literature and a meta analysis of the epidemiology data, to explain the role of HCV in the development of NHL's lymphoma. Furthermore, the possibility to treat these HCV-related NHL with the antiviral therapy or with other therapeutic options, like chemotherapy, is also discussed.

Extranodal Imaging Manifestations of Non-Hodgkin's Lymphoma

A series of imaging features of extranodal, multi-systemic involvements in Non-Hodgkin's lymphoma (NHL) were investigated The clinical data and imaging findings of 16 patients with pathologically proved NHL were retrospectively analyzed The related literatures were reviewed Of the 16 cases of NHL, skeletal involvement was found in 4, nasal cavity and nasal sinuses were involved in 4, too Lesion in the thorax was seen in 3 patients, hepatic involvement occurred in one case, cerebral ventricle was affected in 3 cases, mesentery was involved in one case Even though extranodal involvement of NHL exhibited extremely variable patterns, there were some relatively typical imaging findings Emphasized in this report were the relatively specific imaging manifestations of different systems, which may mimic infectious or other neoplasms of different sites The importance of imaging studies lies in the availability for diagnosis, staging and follow-up of NHL Combined with the clinical and other related information, the diagnostic accuracy can be further improved, thus, providing reliable evidence in guiding clinical management

STUDIES OF THE CHARACTERISTIC FEATURES OF KI-1 POSITIVE NON-HODGKIN'S LYMPHOMA

The clinical histopathological and immuno-phenotypic features in 5 patients with Ki-1 positive non-Hodgkin's lymphoma (NHL) were studied. When firstseen, 4 patients presented enlargement of superficiallymph nodes, with skin lesions in 2 patients. Two patientsin stage Ⅳ with fever, hepato-splenomegaly and bonemarrow invasion, died. Histologically, the tumor cellsshowed diffused or patchy hyperplasia. The cells wererelatively large in size, rich in basophilic or slightlyeosinophilic cytoplasm with irregular-shaped nuclei,prominent nucleoli, and distinct anaplasia andpleomorphism. Some of the cells looked very much likethe Reed-Sternberg cells. Multinucleated giant cells wereseen. Immunophenotypically, all the cells were CD30 (Ki-1) and CD25 (IL-2 receptor) positive but CD15 (Leu M1)negative. Thus, the 5 patients with Ki-1 positive NHLwere all of T cell type.

Hepatitis B Reactivation with Novel Agents in Non-Hodgkin's Lymphoma and Prevention Strategies

Hepatitis B virus (HBV) infection remains an endemic disease in most parts of the world despite available prophylactic vaccines.Non-Hodgkin's lymphoma is the most common hematological malignancy,and certain patients undergoing therapy are at increased risk of HBV reactivation.Rituximab,a monoclonal antibody,is well studied in HBV reactivation,but newer agents have been implicated as well.Here,we review novel agents suspected in HBV reactivation and effective strategies to prevent HBV reactivation.Fifteen years of literature were reviewed in order to better understand the reactivation rates of hepatitis B in patients with non-Hodgkin's lymphoma.Anti-CD20 antibodies continue to be the main medications that can lead to HBV reactivation,and HBV reactivation rates have decreased with increased awareness.HBV reactivation is uncommon when using other novel agents.Entecavir and lamivudine remain the agents of choice to prevent HBV reactivation in high risk patients.In conclusion,the immunosuppressive effect of NHL and its therapy provide a pathway for HBV reactivation,especially in patients treated with anti-CD20 antibody.Since many HBV positive patients are often excluded from clinical trials of novel agents in NHL,more aggressive post-market surveillance of new agents,welldesigned best practice advisories,and timely case reports are needed to reduce the incidence of HBV reactivation.Lastly,large prospective investigations coupled with well-utilized best practice advisories need to be conducted to understand the impact of more potent novel NHL therapy on HBV reactivation.(C) 2016 The Second Affiliated Hospital of Chongqing Medical University.Published by XIA & HE Publishing Inc.All rights reserved.

Primary Lymphoma of Respiratory System (A Report of 11 Cases)

Objective: To analyze the clinical and pathologic features and the treatmentoutcomes of primary lymphoma of respiratory system (PLRS). Methods: The clinical manifestation,imaging changes, pathologic subtypes, treatment and overall survival of 11 patients with PLRS wereanalyzed retrospectively. Results: Of the 11 patients diagnosed with PLRS by histopathology, thetumor of 2 patients occurred in trachea and the other 9 in lung. Cough, dyspnea and fever were themost frequent symptoms. Mass or infiltrative changes could be found on the chest X-ray and/or CTscan. Two patients were diagnosed as having Hodgkin's Lymphoma (HL) and 9 having non-Hodgkin'sLymphoma (NHL), including 7 patients with low degree NHL [5 of them (55.6%) were mucosa-associatedlymphoid tissue (MALT) lymphoma] and 2 with intermediate degree NHL. Of 10 patients undergoingexploratory thoracotomy and surgical treatment, 8 received adjuvant chemotherapy and 2 adjuvant ofradiotherapy. The remaining patient was subjected to combined chemotherapy. Both of HL patientssurvived more than 5 years without clinical disease. The median survival of MALT lymphoma and othertype of NHL was 39 months and 34 months respectively. Conclusion: Both the clinical manifestationand imaging changes are non-specific. The diagnosis was made through exploratory thoracotomy (10cases) and fiber-optical bronchoscopy (1 case). MALT lymphoma is the most frequent pathologicsubtype. Majority of patients are diagnosed and treated by surgical resection. The prognosis isacceptable.

原发性中枢神经系统淋巴瘤的ＭＲＩ影像诊断及病理特点

目的:分析免疫力正常患者的原发性中枢神经系统淋巴瘤(PCNSL)的MRI特征,提高对该病的术前影像诊断。材料和方法:回顾性分析23例经病理证实的PC-NSL的MRI资料和病理资料。结果:23例PCNSL中,单发16例(69.6%),多发7例(30.4%),共41个病灶,幕上39个病灶,幕下2个病灶。78.0%(32/41)病灶平扫T1WI呈等、低信号,T2WI等、稍低信号,较大的病灶中均未见血管流空;增强后70.7%(29/41)病灶呈均匀实质团块状或结节状明显强化,典型的出现"缺口征"、"尖角征",并靠近蛛网膜下腔;9.8%(4/41)病灶出现囊变,可见"硬环征"。病理证实均为B细胞来源非霍奇金淋巴瘤,除1例为Burkitt淋巴瘤,其余均为弥漫性大B细胞淋巴瘤,镜下肿瘤细胞弥漫分布,瘤细胞大小较一致,胞质少,核大,染色质颗粒粗,15例(65.2%)可见瘤细胞围绕血管呈袖套样浸润,所有病例均未见出血、坏死,钙化。结论:PCNSL的病理学基础决定其MRI表现具有一定特征性,典型的病例,常规MRI多可作出正确的诊断,确诊有赖于病理。

利妥昔单抗联合化疗治疗弥漫型大B细胞淋巴瘤的临床观察

目的:探讨利妥昔单抗联合化疗治疗弥漫型大B细胞淋巴瘤患者的临床疗效和安全性。方法:回顾性分析100例病理确诊为弥漫型大B细胞淋巴瘤患者的临床资料。所有患者均接受2～8次的利妥昔单抗治疗,利妥昔单抗的平均治疗次数为5.8次。同时,所有患者均接受了化疗。评价疗效和不良反应。结果:100例患者中达完全缓解者46例(46%),达部分缓解者37例(37%),总有效率(完全缓解+部分缓解)为83%(83/100)。红细胞沉降率、国际预后指数评分、是否为初治患者、B症状以及利妥昔单抗治疗周期数对疗效有显著影响(P<0.05),而性别、年龄、原发部位和功能状态评分对疗效无影响(P>0.05)。1、2、3和5年生存率分别为87.5%、72.8%、60.8%和60.8%。COX回归模型多因素分析发现,国际预后指数评分、利妥昔单抗治疗周期数和治疗后的疗效对生存的影响有统计学意义(P<0.05)。100例患者中共有11例因静脉输注利妥昔单抗而发生输液不良反应。结论:利妥昔单抗联合化疗治疗弥漫型大B细胞淋巴瘤的临床缓解率较高,患者耐受良好且生存时间较长。

结外侵犯非霍奇金淋巴瘤224例的临床病理特征及疗效分析

目的:探讨初治时伴结外侵犯的非霍奇金淋巴瘤(non-Hodgkins lymphoma,NHL)的临床病理特征及其与疗效的关系。方法:回顾性分析初治伴结外侵犯的NHL患者224例,分析其临床病理特征,采用χ2检验,比较不同临床特征与完全缓解率之间的关系。结果:224例伴结外侵犯的患者中B细胞NHL140例,主要为弥漫大B细胞淋巴瘤(77例);T细胞NHL84例,主要为外周T细胞淋巴瘤非特指型(53例)。伴结外侵犯的B细胞NHL,最常见的侵犯部位是咽淋巴环、胃肠道和浆膜腔;伴结外侵犯的T细胞NHL,最常见的侵犯部位是咽淋巴环和鼻腔副鼻窦。B细胞NHL完全缓解率为34.3%(48例),T细胞NHL完全缓解率为31.0%(26例)。Ⅲ～Ⅳ期、B症状、体能状况差、巨大包块者完全缓解率低;性别、LDH及是否放疗与完全缓解率无相关性,P>0.05;国际预后指数(IPI)不同的患者,其完全缓解率差异有统计学意义(B细胞性淋巴瘤P=0.023,T细胞性淋巴瘤P=0.014)。结论:伴结外侵犯的NHL最常见的病理类型是弥漫大B细胞淋巴瘤和外周T细胞淋巴瘤非特指型,其完全缓解率低,可以利用IPI指数预测其疗效与预后。

原发性甲状腺淋巴瘤8例分析

目的 分析原发性甲状腺淋巴瘤的误诊及术后并发症发生原因，探讨减少误诊及术后并发症的措施。方法 回顾我科1992-2005年住院治疗的8例原发性甲状腺淋巴瘤患者的临床资料并进行分析。结果 8例原发性甲状腺淋巴瘤术前均被误诊为甲状腺癌。常规病理检查确诊2例，常规病理加免疫组化确诊6例。术后并发症主要为声嘶。结论 原发性甲状腺淋巴瘤易发生临床误诊和病理误诊，全面掌握原发性甲状腺淋巴瘤的临床表现、重视细针穿刺和快速冰冻切片检查，结合免疫组化检测结果是减少原发性甲状腺淋巴瘤误诊的有效措施。原发性甲状腺淋巴瘤的早期诊断与综合治疗对减少术后并发症至关重要。

Pancreatic T/histiocyte-rich large B-cell lymphoma: A case report and review of literature

Primary pancreatic lymphoma(PPL)is an extremely rare form of extranodal malignant lymphoma.The most common histological subtype of PPL is diffuse large B cell lymphoma(DLBCL).In rare cases,PPL can also present as follicular lymphoma,small lymphocytic lymphoma,and T cell lymphoma either of non-Hodgkin’s lymphoma or of Hodgkin’s lymphoma.T-cell/histiocyterich large B-cell lymphoma(T/HRBCL)is an uncommon morphologic variant of DLBCL with aggressive clinical course,it is predominantly a nodal disease,but extranodal sites such as bone marrow,liver,and spleen can be involved.Pancreatic involvement of T/HRBCL was not presented before.Herein,we report a 48-year-old male who was hospitalized with complaints of jaundice,dark brown urine,pale stools,and nausea.The radiological evaluation revealed a pancreatic head mass and,following operative biopsy,the tumor was diagnosed as T/HRBCL.The patient achieved remission after six cycles of CHOP chemotherapy.Therefore,T/HRBCL can be treated similarly to the stage-matched DLBCL and both of them get equivalent outcomes after chemotherapy.

脑原发性恶性淋巴瘤3例

脑原发性恶性淋巴瘤(PBML)罕见,我们遇到3例,均做了光镜和电镜观察。1 临床及病理资料 3例(男2,女1)患者,年龄均在50岁以上。主要表现为头痛,肢体活动受限或偏瘫等。神经外科检查可见软瘫及病理反射。两例瘤体均位于硬脑膜下,分界清楚、质稍硬,1例位于胼胝体前,边界不清。

STAT3,STAT5在EBV相关鼻NK/T细胞淋巴瘤中的表达

目的研究STAT3和STAT5在EBV相关鼻NK/T细胞淋巴瘤中的表达及其临床意义。方法在25例鼻NK/T细胞淋巴瘤中用免疫组化方法检测LMP1、STAT3和STAT5的表达,原位杂交检测EBER1/2的表达。分析STAT3、STAT5与鼻NK/T细胞淋巴瘤临床病理特征的关系。20例慢性鼻窦炎的鼻腔淋巴组织作对照。结果EBER1/2和LMP1的阳性率在鼻NK/T细胞淋巴瘤中分别为92%和60%,而对照组EBER1/2和LMP 1的阳性率分别为2 0%和1 5%。STAT3在鼻NK/T细胞淋巴瘤和对照组中的阳性率分别为5 6%和1 0%(P<0.05);STAT5在鼻NK/T细胞淋巴瘤和对照组中的阳性率分别为为68%和15%(P<0.05)。STAT3和STAT5的表达与LMP1表达均成正相关(r=0.428,P<0.05和r=0.490,P<0.05)。缓解组和复发组STAT 3阳性率分别为73.3%和30%(P<0.05)。缓解组和复发组STAT 5阳性率分别为93.3%和3 0%(P<0.01)。Cox回归分析显示STAT5是独立的预后影响因子。结论STAT3和STAT5可能参与EB病毒相关鼻NK/T细胞淋巴瘤的发生,并且STAT3和STAT5表达状况与肿瘤复发有关;STAT5是独立的预后因子。

非霍奇金淋巴瘤中p16基因异常的关系研究

目的研究p16基因异常在非霍奇金淋巴瘤发生发展中的作用。方法采用PCR-SSCP法对40例NHLs进行p16基因外显子2的点突变及纯合性缺失研究。结果40例NHLs中,p16基因点突变率为30%(12/40),纯合性缺失率为5.0%(2/40)。结论p16基因的突变及缺失与非霍奇金淋巴瘤发生发展的关系密切。

Therapeutic Efficacy of L-asparaginase in the Treatment of Refractory Midfacial Peripheral T-Cell Non-Hodgkin’s Lymphoma

Objective: To improve the efficacy of refractory midfacial peripheral T-cell non-Hodgkin’s lymphoma (MPTC-NHL) with L-asparaginase (L-ASP) based salvage chemotherapy. Methods: 21 patients with refractory MPTC-NHL were analyzed. 11patients (L-ASP group) received L-asparaginase based salvage chemotherapy consisting of L-asparaginase, vincristine and dexame-thosone. 10 patients (control group) received salvage combination chemotherapy without L-asparaginase. Results: Complete remission rates were 45.6% for L-ASP group and 0.0% for control group (p<0.05). Overall response rates (CR+PR) were 63.6% for L-ASP group and 10.0% for control group, respectively (p<0.05). 2-year survival rates were 45.5% for L-ASP group and 0.0% for control group (p<0.05). The major adverse effects of L-ASP were leukopenia, elevation of serum bilirubin and hyperglycemia. Conclusion: The preliminary clinical study shows that the L-ASP based salvage chemotherapy may improve the response rate and 2-year survival rate of the patients with refractory MPTC-NHL. It is necessary to continue the study further.

原发性脑淋巴瘤与脑膜瘤的影像表现及病理对照分析

目的:对照分析原发性脑淋巴瘤与脑膜瘤的影像表现及病理特征。方法:回顾性分析经病理证实的10例原发性脑淋巴瘤和30例脑膜瘤的CT、MRI及病理资料。结果:10例原发性脑淋巴瘤,单发病灶6例,多发病灶4例。肿块位于深部脑组织8例,位于脑膜表浅组织2例,1例出现囊变坏死区,6例出现握拳征,1例出现脑膜尾征,肿块均无钙化灶。DWI均呈现高信号。病理类型均为B细胞型非霍奇金淋巴瘤。30例脑膜瘤均为单发病灶。肿块位于深部脑组织7例,位于脑膜表浅组织23例。14例形成脑膜尾征,5例出现囊变坏死区,12例出现钙化灶,未出现握拳征。DWI呈现低信号6例,等信号10例,高信号14例。病理类型均为脑膜瘤。通过统计学分析发现,两者在肿块单发多发、好发部位、脑膜尾征、钙化灶、握拳征、DWI信号方面差异具有统计学意义(P<0.05)。结论:原发性脑淋巴瘤与脑膜瘤的影像表现各有特征,但也有类似之处,仔细分析影像学表现能提高准确率,明确诊断需依据术后病理。

原发性肺淋巴瘤18例临床和影像及病理特点

目的探讨原发性肺淋巴瘤（PPL）的临床表现、病理和影像学特点、诊断及治疗方法，提高其诊断率。方法回顾性分析1989年1月至2007年2月北京协和医院住院的原发性肺淋巴瘤18例，总结其临床表现、病理和影像学特点、诊断手段、治疗方法及预后。生存时间按月记录，以手术日至患者最后一次就诊时间为准。计量资料采用秩和检验，计数资料采用卡方检验。使用SPSS10．0统计软件进行数据分析。结果18例中男6例，女12例，年龄17～71岁，中位年龄47．5岁。外科肺活检确诊15例（其中1例曾行经支气管镜活检发现肿瘤细胞，但未能明确病理类型），经皮肺活检确诊1例（1／6），经皮肺活检及经支气管镜活检标本共同确诊1例，经支气管镜活检确诊1例（1／10）。病理结果为霍奇金淋巴瘤2例，其中混合细胞型和结节硬化型各1例；黏膜相关淋巴组织淋巴瘤9例，滤泡性淋巴瘤1例，弥漫性大B细胞淋巴瘤2例，间变性大细胞淋巴瘤2例，2例外院切片我院会诊后诊断为非霍奇金淋巴瘤。主要症状为咳嗽（11／18）和发热（6／18）。18例中影像学表现为肺内结节或团块影14例，片状浸润影11例，实变影5例。胸腔积液和肺不张各5例，肺门或纵隔淋巴结肿大7例，空洞病变1例，病灶内液化1例。11例曾被误诊。3例手术完全切除病灶，8例单纯化疗，6例在肺叶切除术后化疗，1例放疗及化疗。中位随访时间为11个月（10d至205个月），目前存活13例，失访4例，死亡1例。非霍奇金淋巴瘤患者白细胞异常升高与疾病进展（预后不良）相关，预后不良组中位数为25、1×10^9／L（18．1～39．1）×10^9／L，预后良好组中位数为6．7×10^9／L（5．48～8．41）×10^9／L，u=0．000，P〈0．05。结论PPL临床表现不典型，易误诊；及时行外科肺活检获取组织病理标本有利于早期诊断。

574例儿童眼部肿瘤的临床统计与分析

目的了解儿童眼部肿瘤的常见种类,临床与病理特点以及最新的研究动态.方法对我院1995年至2004年10年间574例儿童眼部肿瘤的发生部位,临床特点及病理分型进行回顾性分析.结果 574例儿童眼部肿瘤中,男性316例,女性258例,发病年龄从56天至14周岁,在2～3岁和10～11岁时呈两个高峰,平均发病年龄5.63岁,其中良性肿瘤347例(60.5%),恶性肿瘤227例(39.5%).眼睑和眼表肿瘤225例(39.2%)中,良性肿瘤占98.7%,主要为上皮来源良性肿瘤,而罕见的一例鳞癌见于着色性干皮病患儿;眼眶肿瘤136例(23.7%),良性肿瘤(87.5%)中最常见的是皮样囊肿,血管源性和神经源性良性肿瘤,恶性肿瘤(12.5%)以横纹肌肉瘤和神经母细胞瘤多见;而眼内肿瘤213例(37.1%)中恶性者占97.2%,视网膜母细胞瘤205例,脉络膜淋巴瘤和睫状体恶性肿瘤各1例.结论儿童眼部肿瘤与成人眼部肿瘤不同,以先天性和胚胎性肿瘤为主,其中恶性肿瘤主要为原发性肉瘤和胚胎性肿瘤,有时与良性肿瘤和炎症鉴别诊断困难.

鼻腔NK／T细胞淋巴瘤中p53和p21表达及其与细胞增殖和凋亡的关系

目的:探讨p53、p21蛋白在鼻腔NK/T细胞淋巴瘤(nasal NK/T-cell lymphoma,NKTL)中的表达,及其与细胞增殖和凋亡的关系。方法:取62例NKTL组织构建组织芯片,应用免疫组织化学方法检测p53、p21、Ki67蛋白的表达情况,TUNEL法原位凋亡检测,计算增殖指数(proliferation index,PI)和凋亡指数(apoptosis in-dex,AI)。结果:①p53、p21蛋白在NKTL中表达的阳性率分别为79.03%、58.06%;②p53在Ann ArborⅠ、Ⅱ、Ⅲ、Ⅳ期患者中表达的阳性率分别为69.57%、75.00%、86.67%、100.00%,p21在Ann ArborⅠ、Ⅱ、Ⅲ、Ⅳ期患者中表达的阳性率分别为47.83%、56.25%、60.00%、87.50%,随着肿瘤进展,二者表达阳性率逐渐升高,差异有统计学意义(P<0.05);③p53在大、中、小型瘤细胞患者中表达的阳性率分别为92.86%、78.95%、53.33%,p21在大、中、小型瘤细胞患者中表达的阳性率分别为67.86%、57.89%、40.00%,随着肿瘤细胞增大,二者表达阳性率逐渐升高,差异有统计学意义(P<0.05);④p53和p21二者表达之间统计学上具有明显的相关性(P<0.05);随着p53、p21蛋白表达强度的增加,肿瘤临床分期增高,肿瘤细胞增大,PI亦逐渐升高,它们均与PI呈正相关(P<0.05),而与AI无关联性(P>0.05)。结论:p53、p21蛋白表达与NKTL的发生、发展密切相关,联合检测Ki67表达,可作为评估该病患者肿瘤细胞增殖、侵袭性等生物学行为的良好指标。