老年弥漫大B细胞淋巴瘤患者预后影响因素分析

目的:探讨老年弥漫大B细胞淋巴瘤（DLBCL）患者的预后及其影响因素,为临床治疗提供参考。方法:回顾性分析山西省肿瘤医院2013年1月至2017年6月152例≥60岁DLBCL患者的临床资料。采用Kaplan-Meier法进行生存分析,并通过log-rank检验对患者预后影响因素进行单因素分析,多因素分析采用Cox比例...     

原发韦氏环非霍奇金淋巴瘤50例临床特征和预后分析

目的 比较原发韦氏环非霍奇金淋巴瘤(WRNHL)常见病理类型的临床特征与预后差异.方法 对2008年1月至2013年12月收治的50例原发WRNHL患者的临床资料进行回顾性分析.Kaplan-Meier法计算生存率,用Log-rank法检验组间差异并行单因素预后分析.结果 原发WRNHL常见病理类型为弥漫大B细胞淋巴瘤(DLBCL)与结外鼻型NK/T细胞淋巴瘤(ENKTCL),其中DLBCL占56％(28/50),ENKTCL占34％(17/50).DLBCL的发病年龄明显大于ENKTCL,两者原发部位不同,50.0％(14/28)的DLBCL患者原发于扁桃体,88.2％(15/17)的ENKTCL原发于鼻咽部;DLBCL的近期疗效远优于ENKTCL, DLBCL的总生存率、无进展生存率均优于ENKTCL,差异均有统计学意义(x2=4.45,P=0.035;x2=6.47,P=0.011).结论 DLBCL和ENKTCL的临床特征不同,DLBCL的近期疗效及预后明显优于ENKTCL.     

非霍奇金淋巴瘤预后因素的初步分析

目的:初步分析非霍奇金淋巴瘤患者临床病理因素与预后的关系.方法:回顾性分析我院70例非霍奇金淋巴瘤患者的性别、年龄、ECOG评分、恶性程度、临床分期、最大肿瘤直径、结外受累部位数、有无B症状、LDH、β2微球蛋白、疗效及肿瘤进展时间(TTP)等.应用SAS 8.2统计软件分析各临床病理因素与预后的关系.结果:单因素分析显示,年龄(P=0.040)、ECOG评分(P=0.032)、临床分期(P=0.033)、最大肿瘤直径(P=0.028)、结外受累部位数(P=0.000)、血清乳酸脱氢酶(LDH,P=0.041)和疗效(P=0.000)是影响TTP的单个因素.多因素分析显示,ECOC评分(P=0.046)、临床分期(P=0.035)、最大肿瘤直径(P=0.021)、结外受累部位数(P=0.007)和疗效(P=0.000)影响TTP的独立预后因素.结论:ECoG评分、临床分期、最大肿瘤直径、结外受累部位数、疗效等许多临床病理因素影响着患者的预后.     

180例黏膜相关淋巴瘤患者的临床特征和预后分析

目的:对黏膜相关淋巴组织(mucosa associated lymphoid tissue,MALT)进行较大样本的单中心回顾性分析,获取其临床特征及生存相关影响因素数据。方法:回顾性分析2012年9月至2019年5月陆军军医大学大坪医院经病理活检确诊的180例MALT淋巴瘤患者。结果:全组180例患者,其中男性99例(55.0%),女性81例(45.0%),发病年龄31～84岁,中位年龄57岁。原发部位为胃肠59例(32.8%),眼66例(36.7%),其他结外原发部位包括肺、咽淋巴环、甲状腺、腮腺和睾丸等,共55例(30.6%)。临床分期Ⅰ～Ⅱ期173例(96.1%),Ⅲ～Ⅳ期7例(3.9%)。胃肠组、眼部组和其他组5年生存率(overall survival,OS)分别为96.7%、95.5%和86.4%,差异无统计学意义(P=0.118);5年无进展生存率(progression-free survival,PFS)分别为82.4%、86.6%和86.4%,差异无统计学意义(P=0.862)。预后单因素相关分析提示,低血红蛋白水平(P=0.006)、β2-微球蛋白(β2-MG...     

侵袭性非霍奇金淋巴瘤预后相关因素分析

目的研究探讨侵袭性非霍奇金淋巴瘤的预后影响因素。方法回顾性分析137例侵袭性非霍奇金淋巴瘤的临床特征,结合随访资料,应用SPSS 10.0统计软件进行生存分析,并对其预后影响因素进行多因素分析。结果放化疗后达CR者35例(25.5%),其中近期CR 31例(22.6%), PR 67例(48.9%),SD 6例(4.3%),PD 29例(21.2%),总有效率为74.5%。4年总生存率为70.8%,4年无复发生存率为42.7%。Cox模型多因素分析显示,临床分期为Ⅲ～Ⅳ期、PS评分≥2分、累及淋巴结外病变数≥2个与预后关系密切,具有统计学意义。结论侵袭性非霍奇金淋巴瘤通过放化疗综合治疗,生存率有了较大提高。对于不同类型的NHL如何实施个体化的治疗方案,仍需进一步探讨。     

鼻型NK/T细胞淋巴瘤临床病理特征及预后分析

目的探讨鼻型NK/T细胞淋巴瘤临床病理特征及预后影响因素。方法回顾性分析经病理证实的31例该病患者的临床资料。结果鼻型NK/T细胞淋巴瘤容易误诊;3年及5年生存率分别为58.1%和33.3%;随着分期增高,生存率明显下降;有B症状者或IPI评分≥2者,其生存率分别显著低于无B症状者或IPI评分<2者;综合治疗组3年生存率显著高于单纯化疗组。结论鼻型NK/T细胞淋巴瘤的诊断应结合其临床特征、形态学、免疫表型及遗传学改变综合确定;AnnArbor分期、IPI及B症状是影响预后的重要因素;综合治疗可能是目前最佳的治疗选择。     

非霍奇金淋巴瘤的预后因素

在30多年前,中、高度恶性非霍奇金淋巴瘤患者,如未及时治疗,往往短期内就会死亡.现今,由于科学技术的发展和一系列新治疗方案问世,使这种疾病的缓解率有了显著的提高,其治愈率达到了40%.     

40例原发性胃肠道弥漫大B细胞淋巴瘤临床特征、细胞来源与预后分析

背景与目的:原发性胃肠道弥漫大B细胞淋巴瘤(primary gastrointestinal diffuse large B-cell lymphoma,PGI-DLBCL)的发病部位及其临床表现与胃肠道其它肿瘤性疾病难以鉴别,误诊率较高,且其标准治疗的方法仍未确定。本研究旨在分析PGI-DLBCL的临床特征、肿瘤细胞来源及预后,并探讨有效的联合治疗方法。方法:分析我院1998～2007年诊治的40例PGI-DLBCL,应用Kaplan-Meier法、log-rank检验和Cox回归模型对其临床资料和实验室检测结果进行生存分析及单因素和多因素预后分析。通过免疫组化染色分析34例患者的肿瘤细胞来源。治疗方法包括联合化疗、手术 联合化疗及放疗、单纯手术等,联合化疗方案为CHOP及CHOP样方案。结果:40例PGI-DLBCL患者中,年龄10～89岁中位年龄56.5岁,男女比例1.86∶1,胃与肠道的发病比率为1.05∶1。预后分析可追访病例38例中,死亡12例(31.6%),3年和5年生存率均为64.7%。9例多部位发病的患者中,8例(88.9%)在3年内死亡。9例(26.5%)肿瘤细胞来源于生发中心(germinal center,GC),25例(73.5%)来源于非生发中心(non-germinal center,non-GC)。单因素预后分析发现肿瘤细胞来源、国际预后指数(international prognosis index,IPI)、B症状对生存率的影响有显著性(P<0.05)。Cox多因素预后分析显示血清乳酸脱氢酶(LDH)升高组患者的死亡风险是LDH正常组的2.87倍。结论:PGI-DLBCL发病以中年男性为主,多部位发病是该类患者死亡的重要原因。肿瘤细胞来源、IPI、B症状对预测患者生存和指导治疗有重要作用,其中初诊时血清LDH水平升高是本组患者的独立预后因素。     

111例T细胞非霍奇金淋巴瘤的临床预后分析

背景与目的：T细胞非霍奇金淋巴瘤(non-Hodgkin's lymphoma,NHL)是一组异质性淋巴系统恶性疾病,我国较西方国家多见,预后不良．目前尚无理想的治疗方案。本研究回顾性分析111例T细胞淋巴瘤的临床特征与预后的关系。方法：选取1994年1月～2001年12月中山大学肿瘤防治中心收治有完整临床资料的T细胞NHL 111例．所有的病例按WHO 2001分类标准进行病理分型,并对其临床资料进行分析,总结其与预后的关系。结果：111例患者的中位年龄是37岁(7～77岁),82例患者为男性,女性29例．中位生存期28个月,3年总生存率为45％。45例(40．5％)患者采用化、放联合的治疗方式,62例(55．8％)患者采用单纯化疗,4例(3．6％)患者采用单纯放疗;化放联合治疗组、单纯化疗组和单纯放疗组患者的3年生存率分别为56％、38％,和25％。所有病理亚型中NK／T细胞淋巴瘤预后最差,3年总生存率只有25％;非特殊性外周T细胞淋巴瘤(PTCL-U)次之,3年总生存率在40％左右：而问变性大细胞性淋巴瘤(ALCL)的3年总生存率接近85％。Ⅰ Ⅱ期患者较Ⅲ Ⅳ期患者有更好的生存期．淋巴瘤国际预后指征是预测生存期的一个重要因素。低危组、低中危组、中高危组以及高危组的3年生存率分别为60％、30％、10％和0％。结论：对于T细胞来源的淋巴瘤尤其是分期较晚和IPI评分高危的患者．目前的治疗方案并不能取得令人满意的结果,需要探索新的治疗方法。     

弥漫大B细胞淋巴瘤患者血清β2-MG、VEGF、bFGF、IL-6水平与国际预后指数的关系

目的：探讨弥漫大B细胞淋巴瘤（diffuse large B cell lymphoma，DLBCL）患者血清血管内皮生长因子（vascular endothelial growth factor，VEGF）、白介素-6（interleukin-6，IL-6）、碱性成纤维生长因子（basic fibroblast growth factor，bFGF）、β2微球蛋白（β2-microglobin，β2-MG）水平与国际预后指数（international prognostic index，IPI）之间的关系。方法：33例初治DLBCL患者按IPI评分分成低危组（IPI〈2）和中高危组（IPI≥2），采用ELISA方法检测患者外周血血清中的VEGF、IL-6、bFGF水平，应用放射免疫分析法检测血清β2-MG水平。结果：高危组血清β2-MG、VEGF、bFGF、IL-6水平均较低危组明显升高。结论：血清β2-MG、VEGF、bFGF、IL-6水平可以和IPI一起用于DLBCL患者预后判断，为患者的个体化治疗以及设计新的临床试验提供依据。     

Radioimmunotherapy for patients with relapsed B-cell non-Hodgkin lymphoma

Clinical trials of an yttrium-90 (90Y)-conjugated monoclonal antibody to CD20 in patients with relapsed B cell non-Hodgkin lymphoma (NHL) are reviewed. Ibritumomab is the murine parent anti-CD20 antibody engineered to make the human chimeric antibody rituximab. Tiuxetan is an MX-DTPA linker chelator attached to ibritumomab to form ibritumomab tiuxetan (Zevalin). Ibritumomab tiuxetan can react with indium-111 (111In) or 90Y to form 111In-ibritumomab tiuxetan, which is used for dosimetry, or 90Y-ibritumomab tiuxetan, which is used for therapy of B cell NHL. In this report, the results of five separate clinical trials of ibritumomab tiuxetan are reviewed. Two phase I trials of 90Y-ibritumomab tiuxetan were performed, one using cold ibritumomab prior to 90Y-ibritumomab tiuxetan, and one using rituximab prior to 90Y-ibritumomab tiuxetan. The optimal schedule was found to be rituximab on days I and 8, and 90Y-ibritumomab tiuxetan 0.4 mCi/kg i.v. on day 8; no stem cells or prophylactic growth factors were used. A dose of 0.3 mCi/kg was recommended for patients with a baseline platelet count of 100,000-149,000x10(6)/l. The only significant toxicity was reversible myelosuppression. With this schedule, the overall response rate (ORR) was 67% of all patients and 82% of those with low-grade NHL. The phase I/II trials were followed by a phase III trial that randomized 143 eligible patients to either rituximab or 90Y-ibritumomab tiuxetan radioimmunoconjugate to demonstrate that the combination of the 90Y radioisotope to the murine anti-CD20 antibody provided additional efficacy over the unconjugated ("cold") rituximab alone. A planned interim analysis of the first 90 patients demonstrated an ORR of 80% with 90Y-ibritumomab tiuxetan vs 44% for rituximab (P < 0.05). To provide additional evidence of the benefit of 90Y radioimmunotherapy over rituximab immunotherapy, patients who were nonresponsive or refractory to rituximab were enrolled in an additional trial and treated with 90Y-ibritumomab tiuxetan 0.4 mCi/kg. An ORR of 46% was achieved in these rituximab-refractory patients. These results provide further evidence of the added value of 90Y. Therefore 90Y-ibritumomab tiuxetan radioimmunotherapy is a useful new treatment modality for patients with B cell NHL. Future trials are needed to define the optimal time in the disease course when this modality should be used.     

T-cell-rich B-cell lymphoma. Analysis of clinical features, response to treatment, survival and comparison with diffuse large B-cell lymphoma.

OBJECTIVES: Clinical features, response to treatment and survival of T-cell-rich B-cell lymphoma (TCRBCL) patients were compared to those of a similar group of patients with diffuse large B-cell lymphoma (DLBCL). METHODS: Between 1992 and 1999, 10 patients with a diagnosis of TCRBCL were treated in our department. Over the same 7-year period, a group of 65 patients with DLBCL were diagnosed in the same department. Both groups of patients were treated with the same anthracycline-based chemotherapy. RESULTS: A significantly higher percentage of patients with TCRBCL presented with B-symptoms, elevated LDH, bone marrow infiltration and disseminated extranodal involvement compared to patients with DLBCL. TCRBCL patients responded poorly to combination chemotherapy, since only 3 of them achieved complete remission (33%) compared to 48 (75%) patients with DLBCL. All patients with TCRBCL who achieved complete response relapsed within the first 2 years while 65% of patients with DLBCL survive disease free for a median follow-up period of 4 years. The median overall survival for DLBCL patients has not been reached yet, while it was 18 months for TCRBCL patients. CONCLUSIONS: Although the number of patients in our study is small, it seems that patients with TCRBCL present with advanced disease, respond poorly to chemotherapy and display a short disease-free and overall survival compared to patients with DLBCL.     

Outcomes of very elderly patients with aggressive B-cell non-Hodgkin lymphoma treated with reduced-dose chemotherapy

Background

Although the number of patients aged 80 years or older with aggressive B-cell non-Hodgkin lymphoma (B-NHL) has increased in the clinical setting, management has been challenging due to lower tolerability. The aim of the present study was to evaluate the efficacy and safety of reduced-dose chemotherapy for very elderly patients.

Methods

We retrospectively analyzed the clinical outcomes of patients aged ≥80 years old with diffuse large B-cell lymphoma (n = 58) or grade 3 follicular lymphoma (n = 3).

Results

Patient ages ranged from 80 to 93 years old, with a median of 83 years old. Twenty-four patients were treated with CHOP or THP-COP, the dosages of which were variably reduced, in combination with rituximab (R-vCHOP), while another 24 patients were treated with R-miniCHOP. Twelve R-vCHOP and 16 R-miniCHOP patients completed the chemotherapy cycles. The estimated 2-year progression-free and overall survival rates in the R-vCHOP and R-miniCHOP groups were 53 and 39 % (P = 0.92) and 53 and 48 % (P = 0.95), respectively. Performance status ≥2, lactate dehydrogenase level >normal, serum albumin ≤3.5 g/dL, C-reactive protein ≥2.0 mg/dL, age-adjusted International Prognostic Score 2/3, and withdrawal from the chemotherapy cycle were associated with poor survival. The frequency of chemotherapy-related hospitalization during the second or later cycles was significantly less in the R-miniCHOP group.

Conclusions

The efficacies of R-vCHOP and R-miniCHOP were similar in patients aged ≥80 years old with aggressive B-NHL. The reduced frequency of hospitalization observed for R-miniCHOP treatment is beneficial for very elderly patients.

     

DA-EPOCH-R方案治疗B细胞非霍奇金淋巴瘤效果观察

目的 观察DA-EPOCH-R方案治疗B细胞非霍奇金淋巴瘤(NHL)的效果及安全性.方法 采用DA-EPOCH-R方案治疗43例B细胞NHL患者,观察近期疗效、不良反应,进行随访,分析生存情况.结果 43例NHL患者共接受203个疗程化疗,中位化疗6个(2~8个)疗程.32例(74.4%)化疗2~4个疗程后达完全缓解(CR).年龄≤60岁与>60岁、 Ⅰ~Ⅱ期与Ⅲ~Ⅳ期、 生发中心来源(GCB)型与非GCB型、双表型与非双表型患者CR率差异均无统计学意义(均P>0.05).中位随访40个月(9~62个月),1、3年总生存率分别为97.6%、92.8%.不良反应为血液学不良反应,化疗结束后的随访期内未见严重不良反应,未出现继发性第二肿瘤.结论 DA-EPOCH-R方案治疗B细胞NHL CR率较高,Ⅲ、Ⅳ期患者的疗效与Ⅰ、Ⅱ期相近,老年患者耐受性良好.     

Clinical features,survival and prognostic factors of primary testicular diffuse large B-cell lymphoma

Objective： To assess the clinical features, survival and prognostic factors of primary testicular diffuse large B-cell lymphoma （DLBCL）. Methods： A retrospective study of 37 patients with primary testicular DLBCL was carried out from November 2003 to May 2012. Their clinical features, survival and prognostic factors were analyzed. Results： During a median follow-up period of 39.8 months （5.4-93.0 months）, the median progression-free survival （PFS） was 26.2 months （95% CI：0-65 months） and the 3-year overall survival （OS） rate was 78.4%. Within the whole cohort, the factors significantly associated with a superior PFS were limited stage （stage Ⅰ/Ⅱ）, lactate dehydrogenase （LDH） ≤245 U/L, international prognostic index （IPI） ≤1, primary tumor diameter 〈7.5 cm, and patients who had complete response （CR） and received doxoruhicin-contained chemotherapy （P〈0.05）. There was a trend toward superior outcome for patients who received combined therapy （surgery/ chemotherapy/radiotherapy） （P=0.055）. Patients who had CR, primary tumor diameter 〈7.5 cm and IPI score ≤1 were significantly associated with longer PFS at multivariate analysis. Conclusions： Primary testicular DLBCL had poorer survival. CR, primary tumor diameter and IPI were independent prognostic factors. The combined therapy of orchectomy, doxorubicin-contained chemotherapy and contralateral testicular radiotherapy （RT） seemed to improve survival.     

The clinical features,management, and survival of elderly patients with colorectal cancer

BackgroundAs the population ages, the number of elderly patients with colorectal cancer is increasing year by year. However, older people have rarely been the focus of studies on colorectal cancer. Therefore, in the present study, we aimed to carry out a retrospective analysis of this patient subgroup.MethodsA retrospective study of clinical data of patients aged over 80 years who died from colorectal cancer in our hospital between 1993 and 2020 was performed. Logistic regression, the Kaplan–Meier method, and a multivariate Cox proportional hazards model were used to analyze the overall survival and treatment outcomes of the patients.ResultsA total of 87 patients were included in the study. The overall median survival was 45 months. In most patients, the primary lesion was located in the right colon. One-quarter of the patients refused to accept any treatment. Patients with stage IV tumors, who accounted for the largest proportion of the study population, displayed a higher rate of abandoning treatment than did patients of other stages. Almost all patients with stages II and III accepted surgery. Patients who underwent surgery to treat their colorectal cancer had longer survival than those who did not.ConclusionsOld age should not be a reason for giving up treatment for colorectal cancer. The treatment of colorectal cancer patients aged 80 years and above requires individualized evaluation and more aggressive treatment to achieve greater benefits.     

The clinical features,management, and survival of elderly patients with gastric cancer

BackgroundIt is anticipated that the number of elderly patients with gastric cancer (GC) will increase with population aging; however, most studies on GC set the upper age limit at 80 years old, studies on the prognosis of elderly patients with GC over 80 years old is very limited. In this study, we conducted a retrospective analysis of this sub-cohort.MethodsThis retrospective cohort study aimed to analyze the clinical data of patients aged >80 who died of GC in People’s Liberation Army General Hospital between 1985 and 2020. We collected clinical informations about pathological GC types, differentiation degrees, clinical stages, anatomic sites and Bormann types of the selected case. Characteristics of participants, such as smoking, drinking, and tumor history, age, gender, and complications, were also recorded. The Kaplan-Meier method, a multivariate Cox multivariate proportional hazard model, and logistic regression were used to analyze the patient overall survival (OS) rates and treatment outcomes.ResultsThe study included 92 patients (83.7% men) with a median OS of 45 months. The most common site for GC was the gastric antrum (GA), the most common site of metastatic spread was the liver, and the most common pathological GC type was tubular adenocarcinoma/papillary adenocarcinoma (TAC/PAC). Furthermore, the prevalent complications were hypertension, coronary heart disease, and diabetes. Diabetes was a risk factor affecting the total survival time [hazard ratio (HR) =2.326, P=0.029]. The most often-used GC treatment was curative surgery. The survival time was significantly longer in the curative surgery group and curative surgery + adjuvant chemotherapy group compared with the support care group (HR =0.119, P=0.001; HR =0.110, P=0.001). There was no significant difference in survival time among the palliative chemotherapy group, palliative surgery group, and support care group. Tumor staging was significantly correlated with OS rate, the median survival time of patients at stage III and stage IV GC were significantly lower than the median survival time of patients at stage I GC (HR =6.235, P=0.001; HR =30.955, P=0.001).ConclusionsFor patients over 80 years old with good physical conditions in the early stage of GC, more active treatment can still bring better prognosis.     

126 例原发胃弥漫大B 细胞淋巴瘤的临床特点及预后分析

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6 8 ：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。     

利妥昔单抗联合二线化疗药物治疗老年人复发或难治性淋巴瘤

目的 研究利妥昔单抗联合二线化疗药物对老年人复发和难治性非霍奇金淋巴瘤(NHL)的治疗效果及安全性.方法 采用利妥昔单抗联合二线化疗药物治疗复发和难治性NHL患者12例.结果 12例共治疗38个周期,总有效(CR+PR)8例,有效率66.7%,临床收益(CR+PR+SD)11例,收益率91.3%.1年无进展生存率和总生存率分别为41.0%和50.0%.不良反应以自细胞和血小板减少最为常见,但均可耐受.结论利妥昔单抗联合二线化疗方案治疗老年人复发和难治性NHL安全有效,且能耐受.     

老年人EB病毒阳性弥漫大B细胞淋巴瘤临床病理学特点及预后分析

目的 探讨老年人EB病毒阳性（EBV＋）弥漫大B细胞淋巴瘤（DLBCL）的临床病理学特点及预后.方法 采用回顾性研究的方法 ,收集24例老年EBV＋DLBCL患者,以同期EBV-非特指型DLBCL患者为对照,分析老年EBV＋ DLBCL患者的临床病理学特点及预后.结果 24例老年EBV＋DLBCL患者肿瘤细胞形态上主要表现为单一性或多形性肿瘤细胞增生;多形性病例中常可见有地图状坏死.细胞起源免疫分型主要为非生发中心亚型,分别占91.3％（Hans分型）和100.0％（Choi分型）.CD30阳性率为55.0％,高于非特指型EBV-DLBCL（P＜ 0.001）.在总体生存时间方面,R-CHOP方案治疗的老年EBV＋DLBCL患者和＞50岁EBV-DLBCL患者的中位生存时间分别为44.2个月和29.2个月,两者差异无统计学意义（P=0.587）.结论 老年人EBV＋DLBCL肿瘤细胞形态上主要表现为单一性或多形性肿瘤性增生;多形性病例中常可见不规则坏死.CD30阳性率较高,并且主要为非生发中心B细胞亚型.R-CHOP方案治疗的老年EBV＋ DLBCL患者的总体生存时间与同年龄段非特指型EBV-DLBCL患者相近.