原发性乳腺恶性淋巴瘤11例临床分析

为了探讨原发乳腺恶性淋巴瘤(PBL)的临床特点、病理特征及预后影响因素,对11例PBL患者的临床特点及病理类型应用Kaplan-Meier法进行生存分析.本组病例中部位、白蛋白水平、分期、放疗和手术5个因素影响患者预后.双侧痛变患者的生存率较单侧病变者低,P=0.005.监测患者首治前白蛋白水平,伴有白蛋白下降的患者生存率低,两组间差异有统计学意义,P=0.018.11例随着分期的增加,患者的预后也越差,P=0.040.全组中有5例患者接受放射治疗,未接受放疗的患者生存率比放疗者低,P=0.020.首诊进行手术的患者为9例,其与未手术组间差异有统计学意义,P=0.002.初步研究结果提示,PBL是一组罕见的结外淋巴瘤,临床表现不典型,白蛋白水平低和双侧原发患者的预后差,治疗以手术联合化放疗为佳.

Clinical analysis of 11 cases of primary breast lymphoma

The objective of this study was to discuss the clinical characteristics,pathologic features and prognostic influencing factors of primary breast lymphoma(PBL).The clinical characteristics,pathologic types of 11 patients were retrospectively analyzed.The Kaplan-Meier method was used in the survival analysis.Five factors including tumor site,albumin level,clinical staging,radiotherapy and surgery influenced the prognosis of PBL.The survival rate in bilateral breast lesion patients was lower than that of in unilateral breast lesion of patients(P=0.005).Analyzing the level of albumin before treatment,the patient with lower level of albumin had a poor survival rate and there was statistical significance in the differences between these two groups(P=0.018).The higher the staging,the worse the prognosis among these 11 patients(P=0.040).Five cases of patients were given radiotherapy.The survival rate in patients who were not given radiotherapy was lower than that of in patients with radiotherapy treatment(P=0.020).Nine cases of patients were given surgery in the initial treatment and had a significant difference compared with patients who were not given surgery(P=0.002).In conclusion,PBL is a rare extranodal lymphoma with atypical clinical manifestation.Patient with low level of albumin or with bilateral primary breast lymphoma has a poor prognosis,surgery plus postoperative chemotherapy and radiotherapy is the best choice for treating patients with PBL.