摘要
目的观察头颈部原发结外弥漫性大B细胞淋巴瘤(diffuse large B-cell lymphoma,DLBCL)临床病理特征,为预后预测及个体化治疗提供依据。方法收集2010年1月至2020年11月新疆医科大学第一附属医院耳鼻咽喉科、血液科、肿瘤科连续确诊为头颈部原发结外DLBCL的患者62例。结果DLBCL中,男性38例,女性24例,中位年龄为58岁;形态学以中心母细胞型为主,可见星空现象、凝固性坏死,核分裂像和凋亡小体易见;Han’s分型GCB型23例,ABC型34例,无法分类的5例;MYC/bcl-6基因重排双打击淋巴瘤(MYC/bcl-6 DHL)2例,其中1例为双打击合并三表达。Ann Arbor分期早期20例,晚期42例,早期和晚期死亡百分比无差异(χ^(2)=0.707,P=0.400>0.05),早期比晚期的中位生存期长。EB病毒(Epstein-Barr virus,EBV)病毒阳性者2例,中位生存期51个月;EB病毒阴性者31例,中位生存期24个月。生存分析提示:综合治疗方式比手术或化疗的预后好(χ^(2)=8.554,P=0.003<0.05)。结论DLBCL患者综合治疗方式比单纯手术或化疗预后好,期待早期在个体化治疗的基础上开展综合治疗。
Objective To observe clinicopathologic characteristics of primary extranodal diffuse large B-cell lymphoma(DLBCL)in Head and Neck Region,and to provide basis for prognosis prediction and individualized treatment.Methods Sixty-two patients diagnosed with primary extranodal DLBCL in the head and neck from the Department of Otorhinolaryngology,Department of Hematology,Department of Hematology from the First Affiliated Hospital of Xinjiang Medical University from January 2010 to November 2020 were retrospectively analyzed.Results The 62 DLBCL patients who were screened:male 38 cases,female 24 cases,the median age was 58 years;the main morphological lineages were centroblast type with coagulative necrosis,mitotic figures and apoptotic bodies,and starry sky phenomenon;According to the classification of Han’s model,GCB subgroup accounted for 23 cases,ABC subgroup accounted for 34 cases,and unclassified accounted for 5 cases;2 cases were MYC/bcl-6 gene rearrangement double-hit lymphoma(DHL),which one patient was double-hit combined with triple expression.Annarbor staging included 20 cases of early stage and 42 cases of late stage.There was no difference in the percentage of early and late death between DLBCL patients(χ^(2)=0.707,P=0.400>0.05).The median survival time was longer in early stage than in late stage.The median survival time was 51 months in 2 patients with positive EB virus(Epstein-Barr virus,EBV)and 24 months in 31 patients with negative EBV.Survival analysis showed:The prognosis of comprehensive treatment was better than that of surgery or chemotherapy(χ^(2)=8.554,P=0.003<0.05).Conclusions Among DLBCL patients,the prognosis of patients in comprehensive treatment group is better than that of operation group or chemotherapy group,and the comprehensive treatment was expected to carry out based on individual treatment in the early stage.
作者
闫淑芳
李思静
刘波
杨美虹
李新霞
YAN Shufang;LI Sijing;Liu Bo;YANG Meihong;LI Xinxia(The First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China;Xinjiang Medical University,Urumqi 830017,China)
出处
《新疆医学》
2021年第7期743-748,共6页
Xinjiang Medical Journal
基金
新疆医科大学临床医学高峰学科校内配套经费资助项目(项目编号:33-0104006020801)
国家自然科学基金地区基金(项目编号:81660036)
希思科-罗氏实体肿瘤研究基金资助项目(项目编号:Y-Roche2019/2-0061)
关键词
头和颈部
弥漫性大B细胞淋巴瘤
临床病理特征
预后
head and neck
diffuse large b-cell lymphoma
clinicopathologic characteristics
prognostic
作者简介
闫淑芳,女,硕士,主治医师,研究方向:淋巴瘤的研究;通信作者:李新霞,女,博士,主任医师,研究方向:淋巴及造血系统疾病的研究,Email:lxx-patho@163.com。
