摘要
目的:探讨以眼部症状为突出表现的鼻NK/T细胞淋巴瘤(NKTL)的临床特点及预后。方法:对2011-01-2017-12期间收治的42例以眼部症状为突出表现的鼻NKTL患者进行回顾性队列研究。结果:全部患者治疗后完全缓解19例,部分缓解9例,总有效率为66.67%。中位随访时间为39个月,共18例患者死亡。该研究中,患者的性别、年龄>60岁均与预后无关(均P>0.05)。放化疗联合治疗者较单纯放疗或化疗者的3年生存率高(73.3%、16.7%,P<0.01)。伴有B症状者3年生存率为41.7%,与预后无关(P>0.05)。EBV-DNA阳性者预后较差(P<0.01)。Ⅰ期和Ⅱ期患者较Ⅲ期和Ⅳ期患者的预后较好(P<0.01)。国际预后指数≤1分者较≥2分者预后好(83.3%、37.5%,P<0.01)。结论:以眼部症状为突出表现的鼻NKTL早期诊断困难,易误诊。应尽早通过病理活检及免疫组织化学检测明确诊断,必要时应行EBER原位杂交来协助诊断。
Objective：To investigate the clinical features and prognosis of nasal natural killer/T-cell lymphoma（NKTL）with obvious ocular symptoms.Method：We retrospectively analyzed the clinical data of 42 patients with nasal NKTL who prominently showed eye symptoms and were treated from January 2011 to December 2017.Result：After treatment,the patients received complete remission（CR）in 19 cases and partial remission（PR）in 9 cases.The total effective rate was 66.67%.Median follow-up time was 39 months and 18 patients died.In this study,there was no correlation between sex and prognosis（P〈0.05）.Age60 years was not related to the prognosis of the patients（P〈0.05）.The 3-year survival rate of patients treated with radiotherapy and chemotherapy was higher than that of patients treated with radiotherapy or chemotherapy alone（73.3%,16.7%,P〈0.01）.The3-year survival rate of patients with B symptoms was 41.7%,which was not related to prognosis（P〈0.05）.The prognosis of EBV-DNA positive patients was poor（P〈0.01）.Twenty-six patients with stageⅠandⅡhad a better prognosis（P〈0.01）.Patients with international prognostic index（IPI）≤1 had a better prognosis than those with IPI≥2（83.3%,37.5%,P〈0.01）.Conclusion：Nasal NKTL lymphomas with prominent ocular symptoms are difficult to diagnose early and easy to be misdiagnosed.Clinicians should make a definite diagnosis by pathological biopsy and immunohistochemistry as soon as possible,and assist in diagnosis by EBER in situ hybridization if necessary.
作者
胡真真
王英
金晓朗
HU Zhenzhen;WANG Ying;JIN Xiaolang(Department of Nose,the First Affiliated Hospital of Zhengzhou University,Zhengzhou,450052,China)
出处
《临床耳鼻咽喉头颈外科杂志》
CAS
北大核心
2018年第21期1656-1659,1664,共5页
Journal of Clinical Otorhinolaryngology Head And Neck Surgery
关键词
鼻NK/T细胞淋巴瘤
眼部症状
诊断
预后
nasal natural killer/T-cell lymphoma
ocular symptoms
diagnosis
prognosis
