摘要
本文分析我院１９８３年６月至１９８９年１２月收治临床诊断中线恶网，经病理诊断为恶性淋巴瘤患者１０４例。男：女为２．１∶１。年龄１５～７５岁。病程１月～２年８月。首发症状鼻塞、鼻衄、流涕（５５．８％），咽喉痛咽部肿物（２３．１％）。病理类型除１３例为不肯定Ｔ细胞来源或Ｂ细胞淋巴瘤外，其余均为外周Ｔ淋巴瘤。作者认为不应将中线恶网等同于外周Ｔ淋巴瘤，因存在Ｂ淋巴瘤及非淋巴瘤病例。原发部价鼻腔（６２．５％），韦氏环（２７．９％）。临床分期Ⅰ期３５，Ⅱ期５８，Ⅳ期１１。治疗方法：单纯放疗２７例，放疗后化疗４６例，化疗后放疗３１例。用寿命表法计算５年生存率，Ⅰ期９３．９％，Ⅱ期５０．６％，Ⅳ期１６．４％；总计６３％。中线恶网最常侵及鼻腔，局限于鼻腔预后较好，但侵及副鼻窦、外鼻及淋巴结或合并全身症状生存率明显下降。该病对放、化疗不很敏感，建议放疗量５５～６０Ｇｙ，化疗ＣＯＢＶＰ１６Ｐ有一定疗效。
Abstract This study was designed to find out the relationship between midline malignantreticulosis and malignant lymphoma, and possibly be helpful in guiding the clinical diagnosisand treatment. 104 cases which were admitted and treated in our hospital from June 1983 toDecember 1989, with clinical diagnosis of midline malignant reticulosis and pathologicaldiagnosis of malignant lymphoma were analyzed in this study. The male and female ratio was2.1∶1. The range of age was 15-75 years.Duration was one month to 2 years and 8 months. Asregarding to the initial symptoms,nasal obstruction epistasis and profuse nasal dischargeconsisted of 55.8%;24 patients(23.1%)had sore throat and amass in the pharynx. Thepathological type was classified as peripheral T-cell lymphoma, except thirteen cases withB-cell or T-cell unconfirmed lymphoma. The primary location of the lesion was in the nose in62.5%, Waldeyer's ring in 27.9% and others in 9.6%. According to Ann Arbor clinical stagingsystem there were 35 stageⅠ, 58 stage Ⅱ and 11 stage Ⅳ. 35 patiente were complicated withB-symptom. As to the treatment methods, 27 patients were treated with extensiveradiotherapy alone, 46 with radiotherapy followed by adjuvant chemotherapy and 31 withchemotherapy followed by radiotherapy. The actuarial five year survivals were stage Ⅰ 93.9%,stage Ⅱ 50.6%, stage Ⅳ 16.4%and 63 % for the whole group. The authors consider themidline malignant reticulosis should not be taken as equal to peripheral T-cell lymphoma, assome of these cases were diagnosed as B-cell lymphoma or non-lymphoma. It is indicated thatthe stage, extent of the lesion and B symptom may definitely affect patients’ prognosis.
出处
《中华放射肿瘤学杂志》
CSCD
1994年第2期108-111,145,共5页
Chinese Journal of Radiation Oncology
