摘要
目的：分析胃弥漫大B细胞淋巴瘤（DLBCL）的临床特点和预后,以期更好的指导治疗。方法：回顾性收集1999年1月至2012年3月中国医学科学院肿瘤医院收治的初治、胃原发DLBCL患者的临床资料,分析其人口学特点、分期、病理诊断、并发症、治疗和预后等特征。结果：共计纳入研究患者126例,中位年龄49（16~81）岁,男女比例为68：58。病理诊断为单纯DLBCL 96例、MALT伴大B细胞转化27例、伴浆样细胞分化3例。早期患者114例（90.5%）,其治疗方式包括单纯化疗37例、化疗＋放疗39例、手术＋化疗±放疗38例。中位随访48个月,全组患者PFS和OS分别为75.6%和82.7%,早期和晚期患者的PFS分别为77%和41.7%（P=0.005）。早期患者采用单纯化疗、化放疗联合和含手术治疗的PFS分别为67.3%、77.8%和77.8%（P=0.588）。国际预后指数（IPI）评分为0分、1分和〉1分患者的PFS分别为85.4%,74.4%和55.6%（P=0.011）。Ⅰ期和Ⅱ期患者的PFS分别为81.2%和66.1%（P=0.018）。LDH正常和升高患者的PFS分别为86.6%和63.3%（P=0.006）。病理类型为单纯DLBCL和含有MALT成分、生发中心（GCB）和非生发中心（non-GCB）、年龄〉60岁等与预后无关。结论：早期病变比例占胃原发DLBCL患者的绝大多数。早期患者预后良好,手术切除并不能提高疗效。早期患者中IPI〉1分、LDH升高和临床分期Ⅱ期提示预后不良。
Objective： Primary gastric diffuse large B-cell lymphoma （PGLBCL） is a highly common subtype of extranodal non-Hodgkin lymphoma. We analyzed the disease＇s clinical features and prognosis to guide better treatment. Methods： We retrospectively collect- ed data from PGLBCL cases seen from January 1999 to March 2012 in one cancer center. We then analyzed the demographic character- istics, clinical stage, histological diagnosis, complications, treatment, and prognostic characteristics of such patients. Results： A total of 126 patients with median age of 49 years old （range： 16-81 years） were included in the study. The male-to-female ratio was 68：58. A to- tal of 96 patients were pathologically diagnosed with pure diffuse large B-cell lymphoma （DLBCL）, 27 with mucosa-assouated lymphoid （MALT） component, and 3 with plasmacytoid differentiation. Meanwhile, 90% of the patients were in the early stage of the disease. For the early-stage patients, treatment strategy included surgery ＋ chemotherapy ＋ radiotherapy for 38 cases, chemoradiotherapy for 39 cases, chemotherapy alone for 37 cases, and surgery alone for 1 case. Under a median follow up of 48 months, the 4-year progres- sion free survival （PFS） and overall ourvival （OS） rate of the whole group were 75.6% and 82.7%, respectively. PFS rates for early and advanced stage patients were 77% and 41.7% （P=-0.005）, respectively. For the early-stage patients treated with chemotherapy alone, chemoradiotherapy, and surgery with therapy, the PFS rates were 67.3%, 77.8%, and 77.8% （P=0.588）, respectively. The patients with international prognostic index （IPI） score of 0, 1, and 〉1 achieved PFS of 85.4%, 74.4%, and 55.6% （P=0.011）, respectively. The PFS rates were 81.2% and 66.1% （P=0.018） for stages I and 11, respectively, and 86.6% and 63.3% （P=0.006） for the normal and elevated LDH levels, respectively. The pathological type of pure DLBCL or a MALT component, GCB or non-GCB origin, and age more than 60 years old w
出处
《中国肿瘤临床》
CAS
CSCD
北大核心
2016年第14期620-625,共6页
Chinese Journal of Clinical Oncology
关键词
弥漫大B细胞淋巴瘤
胃原发淋巴瘤
化疗
放射治疗
手术
diffuse large B-cell lymphoma, primary gastric lymphoma, chemotherapy, radiotherapy, surgery
