摘要
目的探讨艾滋病(AIDS)合并原发中枢神经系统淋巴瘤(PCNSL)病人的临床特点及预后情况。方法选择本院20例AIDS合并PCNSL病人,脑组织病变经脑活检病理确立诊断,总结其临床特点,分析其预后情况,并与同期89例AIDS合并其他部位淋巴瘤病人比较。结果 20例AIDS合并PCNSL病人占同期病理诊断淋巴瘤者的18.3%(20/109),均为男性,年龄平均为(35.8±14.2)岁,CD4^+T淋巴细胞(简称CD4细胞)计数中位数为27个/μL,其病理类型中弥漫大B细胞淋巴瘤(DLBCL)共13例,伯基特淋巴瘤5例,其他2例为分型不明的高级别B细胞淋巴瘤。8例死亡,4例经化疗缓解,存活,另有8例自动出院。AIDS合并PCNSL病人与AIDS合并系统性淋巴瘤病人相比,起病时间更短,CD4细胞计数更低,预后更差(P<0.05)。结论 PCNSL是AIDS指征性恶性肿瘤之一,与严重免疫缺陷相关,临床表现及脑脊液检查无特异性,诊断需要活检证实,预后较差,及早诊断及治疗是改善预后的关键。
Objective To observe the clinical features and prognosis of primary central nervous system lymphoma(PCNSL) in AIDS patients. Methods The clinical characteristics and prognosis of 20 patients of PCNSL with AIDS diagnosed by biopsy were analyzed and compared with those of 89 patients of systemic lymphoma with AIDS in the same period. Results 18.3% of all patients of lymphoma with AIDS observed was PCNSL. All PCNSL patients were male, at the age of 35.8±14.2 years, and the median of CD4+T count was 27/μL. Among all PCNSL patients, 13 were diffuse large-B-cell lymphoma(DLBCL), 5 were Burkitt’s lymphoma, 2 were uncertain high-grade B cell lymphoma, diagnosed by biopsy. 8 cases died;4 survived after chemotherapy;8 discharged without further treatment among PCNSL patients. Patients with PCNSL had sooner onset, lower CD4 count and worse prognosis compared with those of systemic lymphoma(P<0.05). Conclusion PCNSL is one of AIDS-defining malignancy with advanced immunosuppression. The clinical characteristics and cerebrospinal fluid(CSF) evaluation may not be enough to establish diagnosis of PCNSL, and biopsy usually be essential. Early diagnosis and therapy are beneficial to improve poor prognosis.
作者
王芳
向攀
杨涤
肖江
韩宁
倪量
吴亮
梁洪远
赵红心
张福杰
郜桂菊
WANG Fang;XIANG Pan;YANG Di;XIAO Jiaing;HAN Ning;NI Liang;WU Liang;LIANG Hong yuan;ZHAO Hongxin;ZHANG Fujie;GAO Guiju(Department of In fectious Diseases, Beijing Ditan Hospital, Capital Medical University , 100015 Beijing , China)
出处
《中国艾滋病性病》
CAS
CSCD
北大核心
2019年第3期236-238,242,共4页
Chinese Journal of Aids & STD
基金
国家"十三五"项目--长期抗病毒治疗患者非AIDS相关疾病控制策略研究(2017ZX10202101004)
HIV合并TB患者利福平对于依非韦伦血液浓度的影响研究(Z171100001017053)~~
关键词
原发中枢神经系统淋巴瘤
艾滋病
Primary central nervous system lymphoma(PCNSL)
AIDS
