原发性胃弥漫大B细胞淋巴瘤患者的生存情况及其影响因素分析

目的 探讨原发性胃弥漫大B细胞淋巴瘤(PG-DLBCL)患者的生存情况及其影响因素.方法 回顾性分析184例PG-DLBCL患者的临床资料,记录患者的治疗方案,收集患者的临床资料及随访资料,采用Kaplan-Meier法绘制生存曲线并计算生存率.采用Cox比例风险回归模型对可能影响PG-DLBCL患者生存率的因素进行单因素及多因素分析.结果 所有PG-DLBCL患者均随访5年,其中4例(2.2％)患者失访,125例(67.9％)患者至随访结束时仍然生存,其余55例(29.9％)患者均因PG-DLBCL进展死亡.Kaplan-Meier生存曲线显示,PG-DLBCL患者的1、3、5年总生存率分别为88.3％、71.5％和67.9％.Cox单因素分析结果显示,Lugano分期、有无B症状、血红蛋白(HGB)水平、白蛋白(ALB)水平、乳酸脱氢酶(LDH)水平、β2微球蛋白水平、是否联用利妥昔单抗、有无幽门螺杆菌(Hp)感染对PG-DLBCL患者的预后有影响(P﹤0.05);而性别、年龄、细胞起源对PG-DLBCL患者的预后无影响(P﹥0.05).Cox多因素分析结果显示,有无B症状、HGB水平、ALB水平、β2微球蛋白水平、有无Hp感染对PG-DLBCL患者的预后无影响(P﹥0.05);而Lugano分期、LDH水平和是否联用利妥昔单抗是PG-DLBCL患者预后的独立影响因素(RR=2.323、1.792、0.399,P﹤0.05).结论 Lugano分期为Ⅲ～Ⅳ期、LDH水平升高是PG-DLBCL患者预后的独立危险因素,联用利妥昔单抗可以提高患者的生存率.     

56例原发性胃弥漫大B细胞淋巴瘤患者的临床预后因素分析

目的：探讨原发性胃弥漫大B细胞淋巴瘤（primary gastric diffuse large B-cell lymphoma,PG-DLBCL）的预后影响因素。方法回顾性分析56例PG-DLBCL患者的临床资料及随访数据,采用Kaplan-Meier法估算患者的生存时间,采用Cox比例风险模型进行预后影响因素分析。结果56例PG-DLBCL患者的1年、2年、3年无事件生存率分别为73.2%,71.3%,68.8%,平均无事件生存时间（event-free survival,EFS）为69个月;1年、2年、3年总生存率分别为81.8%,73.3%,70.5%,平均总生存时间（overall survival,OS）为72个月。化疗联合放疗组的平均EFS比单纯化疗组长,差异有统计学意义（P﹦0.039）;不同的Musshoff分期、LDH水平、淋巴瘤国际预后指数（international prognostic index,IPI）评分、β2微球蛋白值、美国东部肿瘤协作组（Eastern Cooperative On-cology Group,ECOG）体能状态（performance status,PS）评分、有无巨块对EFS及OS均有明确的影响（P＜0.05）。影响EFS及OS的独立预后因素为LDH水平及ECOG评分。结论对PG-DLBCL患者推荐采取以化疗为主的非手术治疗,LDH升高及PS评分高是预后不良的重要指标。     

鼻型NK/T细胞淋巴瘤61例预后因素分析

目的 探讨鼻型NK/T细胞淋巴瘤(NKTCL)的临床特点和预后因素.方法 回顾性分析61例鼻型NKTCL患者的临床资料并进行随访.详细的临床特点及实验室检查结果均纳入单因素分析,单因素分析中有统计学意义的指标纳入多因素分析.结果单因素分析显示,Ann Arbor分期、PS评分、IPI、B症状、结外侵犯数、LDH及β-MG水平与鼻型NKTCL患者的生存期有关.多因素分析显示,PS评分、Ann Arbor分期、LDH及β2-MG水平为生存期的独立影响因素.结论 PS评分、Ann Arbor分期、LDH及β2-MG水平为鼻型NKTCL预后的独立影响因素.     

疗前血清Hb水平在早期结外鼻型NK/T细胞淋巴瘤中的预后价值

目的 探讨治疗前血清Hb水平对早期结外鼻型NK/T细胞淋巴瘤预后的影响。 方法 回顾分析2000—2015年间收治的 175例Ⅰ、Ⅱ期结外鼻型NK/T细胞淋巴瘤。纳入标准为原发病灶位于上消化呼吸道,不合并其他恶性疾病,治疗及随访记录完整病例纳入分析。接受单纯化疗 67例、单纯放疗 8例、放化疗 100例。Kaplan-Meier法计算生存率,Logrank法单因素分析,Cox模型多因素分析。 结果 175例患者的变量单因素分析显示疗前血清Hb水平(≥120 g/L)、LDH水平(正常)、ECOG评分(0~1)、Ann Arbor分期(Ⅰ_{E)、接受放疗显著提高PFS及OS (P=0.000~0.046)。多因素分析显示血清Hb水平、LDH水平、ECOG评分、Ann Arbor分期是患者PFS、OS影响因素(P=0.000~0.040)。 结论 疗前Hb≥120 g/L者预后好于<120 g/L者。}     

原发性胃弥漫大B细胞淋巴瘤临床病理学观察及预后因素分析

背景与目的：原发性胃弥漫大B细胞淋巴瘤（primary gastric diffuse large B-cell lymphoma,PG-DLBCL）是胃淋巴瘤最常见的组织学亚型,缺乏特异性临床表现,内镜检查易与胃癌、溃疡或其他炎症性病变混淆,病变组织学形态表现复杂,诊断困难。探索PG-DLBCL的临床病理学特征并分析患者的预后影响因素及生存率。方法：回顾性分析2008年1月—2018年7月南京医科大学附属常州市第二人民医院收治的104例PG-DLBCL患者的临床病理学资料。计数资料两组间比较采用χ ² 检验,应用Kaplan-Meier法计算生存率并绘制生存曲线,Log-rank检验和COX回归模型进行单因素及多因素预后影响分析。结果：104例PG-DLBCL患者,男性45例,女性59例,中位发病年龄68岁。104例患者均获得随访,随访时间6.0~103.0个月,中位随访时间71.0个月,患者中位生存时间56.8个月,1、3和5年总体生存率分别为90.1%、76.8%和47.6%。病理学分类：生发中心样B细胞（germinal center B cell-like,GCB）型40例,非生发中心样B细胞（non-germinal center B cell-like,non-GCB）型64例。荧光原位杂交技术（fluorescence in situ hybridization,FISH）检测结果显示：c-Myc基因异常27例（占26%,其中17例为多拷贝,10例为重排）,B细胞淋巴瘤-2（B-cell leukemia/lymphoma 2,BCL-2）基因异常26例（占25.2%,其中17例为多拷贝,9例为重排）,BCL-6基因异常32例（占31%,其中23例为多拷贝,9例为重排）。单因素分析结果显示,血清CA125水平、血清乳酸脱氢酶（lactate dehydrogenase,LDH）水平、淋巴瘤国际预后指数（international prognostic index,IPI）评分、改良Ann Arbor分期、骨髓侵犯、治疗方法、病理学类型non-GCB型、BCL-2/BCL-6/多发性骨髓瘤原癌基因-1（multiple myeloma protooncogene-1,MUM-1）/细胞分裂周期蛋白7（cell division cyclin 7,CDC7）/微小染色体维持蛋白2（minichromosome maintenance protein 2,MCM2）蛋白表达水平均是影响PG-DLBCL患者预后的相关因素（P＜0.05）。多因素分析结果显示,改良Ann Arbor临床分期ⅢE~ⅣE期、IPI评分≥2、病理学类型非生发中心亚型、CDC7蛋白高表达、MCM2蛋白高表达、FISH检测BCL-2基因重排是影响PG-DLBCL患者预后的独立危险因素。结论：PG-DLBCL发病以老年人为主,临床表现无特殊性,内镜检出率较高,确诊依赖于病理学检查,R（利妥昔单抗）-CHOP（环磷酰胺+表多柔比星+长春新碱+泼尼松）化疗方案作为首选治疗方法。     

原发乳腺非霍奇金淋巴瘤的预后分析

目的 分析原发乳腺非霍奇金淋巴瘤(PNHLB)的临床特点与预后.方法 回顾性分析45例PNHLB的临床特点.5例行乳房改良根治术,5例行患侧乳房单纯切除术.43例行CHOP或CHOP样联合化疗,其中6例加用利妥昔单抗.19例化疗后行局部放疗,1例仅行单纯放疗.45例患者均获随访,随访时间6～180个月.结果 45例PNHLB患者中,弥漫大B细胞性淋巴瘤(DLBCL)37例,T细胞型淋巴瘤4例,黏膜相关淋巴组织样淋巴瘤(MALT)4例.一线化疗的有效率为90.7%.中位总生存期(OS)为6.82年,中位无进展生存期(PFS)为4.25年.Cox比例风险模型分析结果显示,IPI(RR=5.682,P=0.002)、Ann Arbor分期(RR=1.836,P=0.040)是PNHLB患者OS的独立影响因素,中枢神经系统浸润(RR=1.107,P=0.005)是PFS的独立影响因素.结论 国内PNHLB发病年龄较早,以DLBCL最常见.IPI和Ann Arbor分期是PNHLB患者预后的独立影响因素.     

29例 CD5阳性弥漫大B 细胞淋巴瘤患者的临床预后分析

目的：探讨 CD5阳性弥漫大 B 细胞淋巴瘤的预后影响因素。方法回顾性分析了29例 CD5阳性弥漫大 B 细胞淋巴瘤患者临床资料及随访数据,采用 Kaplan-Meier 法估算患者的生存时间,采用 COX 比例风险模型进行预后影响因素分析。结果29例 CD5阳性弥漫大 B 细胞淋巴瘤患者1、2年无事件生存率分别为483%、255%,中位疾病无进展生存时间为10个月。全组患者1、2、3年总生存率分别为586%、449%、318%,中位总生存时间为19个月。单因素分析结果显示：不同的 Ann Arbor 分期、LDH 水平、IPI评分、结外受累范围、病理分型、利妥昔单抗的使用与否对总生存时间有显著影响（P ＜005）。COX 多因素回归分析结果显示：影响总生存时间的独立预后因素为 Ann Arbor 分期、病理类型及利妥昔单抗的使用与否。结论 CD5表达是 DLBCL 的不良预后因素,病理类型、Ann Arbor 分期及利妥昔单抗的使用是 CD5阳性 DLBCL 影响患者总生存期的独立预后因素。     

CXCR4、VEGF在原发性睾丸淋巴瘤中的表达及临床意义

目的 检测CXCR4与VEGF在原发性睾丸淋巴瘤(PTL)中的表达,探讨二者与中枢神经系统浸润和预后的关系。方法 运用免疫组化方法,对59例睾丸淋巴瘤肿瘤组织中的CXCR4和VEGF蛋白表达水平进行检测,分析CXCR4和VEGF蛋白的表达情况以及与各项临床病理特征和预后之间的关系。结果 CXCR4和VEGF蛋白表达高的患者更易中枢神经系统浸润(P＜0.05);两者表达水平存在相关性(φ=0.423,P=0.001);CXCR4蛋白的表达与Ann Arbor分期、IPI评分、血清LDH水平、Ki67密切相关,VEGF蛋白的表达与Ann Arbor分期、IPI评分、B症状、血清LDH水平、是否复发、CR状态密切相关;Ann Arbor分期、IPI评分、B症状、血清LDH水平、CNS受累、完全缓解状态、CXCR4和VEGF蛋白表达水平可能是患者PFS和OS的影响因素,CR状态、CXCR4和VEGF蛋白的表达是PTL患者预后的独立影响因素,是预后差的重要因素。结论 CXCR4、VEGF蛋白高表达的患者具有较高的中枢神经系统受累的风险,因此可作为预测指标,针对高表达的患者提前做好预防措施,进而改善预后;并且可作为潜在的治疗靶点,为临床治疗提供更多的选择。     

血清白蛋白在经典型霍奇金淋巴瘤的临床意义

探讨血清白蛋白（ALB）水平在经典型霍奇金淋巴瘤（CHL）患者预后中的意义。方法:收集2001年5月至2008年12月在中山大学肿瘤防治中心经病理确诊初治的96例经典型霍奇金淋巴瘤患者的临床资料进行回顾性分析。根据ALB水平比较患者的总生存率（OS）和无失败生存率（FFS）。结果:治疗前96例经典型霍奇金淋巴瘤患者中有17例ALB<35 g/L及79例ALB≥35g/L。比较两组患者的基线临床特征,结果显示在年龄、性别、Ann Arbor分期、巨大肿块、结外侵犯、淋巴结区域、LDH水平比较均无统计学差异（P>0.05）。ALB<35 g/L和ALB≥35 g/L患者的5年FFS分别为60.1%和91.6%（P=0.022）,但OS并无统计学意义（P=0.131）。多因素分析结果示仅ALB<35 g/L是FFS的独立预后不良因素（P=0.030）,而OS的独立预后因素为年龄≥60岁（P=0.020）。结论:本研究结果显示治疗前ALB水平对判断CHL患者的预后有一定临床意义,其可能成为一项新的预后指标用于早晚期CHL患者。      

Ⅰ/Ⅱ期韦氏环弥漫大B细胞淋巴瘤免疫化疗后放疗疗效观察

目的 评价免疫化疗后早期韦氏环弥漫大B细胞淋巴瘤(DLBCL)的预后因素及放疗价值。方法 回顾性分析2009-03-21-2017-05-16本院收治的60例Ⅰ/Ⅱ期韦氏环DLBCL患者临床资料。将患者分为放疗组(33例)和未放疗组(27例),均接受利妥昔单抗联合环磷酰胺、多柔比星、长春新碱和泼尼松(R-CHOP)方案的免疫化疗,放疗组在免疫化疗后接受累及野放疗(中位剂量：46 Gy)。生存分析采用Kaplan-Meier曲线描述并行log-rank检验,Cox比例风险模型分析影响预后的因素。结果 全组随访达5年者有46例,5年总生存(OS)率、无进展生存(PFS)率和局部区域控制(LRC)率分别为80.00%、67.95%和84.47%。单因素分析结果显示,Ann Arbor分期为Ⅱ期、美国东部肿瘤协作组(ECOG)评分≥2分、分期改良国际预后指数(smIPI)评分≥2分和未放疗是OS的预后不良因素,Ann Arbor分期为Ⅱ期、ECOG评分≥2分是PFS的预后不良因素,而放疗则是LRC的有利因素。多因素分析结果显示,与OS有关联的因素包括年龄(HR=3.660,95%CI:1.02...     

Clinical heterogeneity of extranodal NK/T-cell lymphoma,nasal type: a national survey of the Korean Cancer Study Group

BackgroundThis national survey was undertaken to propose the classification of extranodal natural killer (NK)/T-cell lymphoma (NTCL) subtypes and to clarify a clinical heterogeneity.Patients and methodsTwo hundred and eighty patients newly diagnosed as NTCL were enrolled from 22 Korean medical centers. Two subsets were compared: one involving the upper aerodigestive tract (UAT) and another involving the non-upper aerodigestive tract (NUAT) region, which comprises the skin, gastrointestinal tract, and liver or soft tissues. Clinical prognostic factors, survival outcomes, and independent predictors for survival were compared between each subset.ResultsNUAT-NTCL (59 patients) had significantly higher proportions of disseminated disease, aggressive biologic features, and unfavorable host reactions compared with UAT-NTCL (221 patients). NUAT-NTCL had shortened 5-year overall survival (OS) (22% versus 41%, P = 0.001). Ann Arbor staging, the International Prognostic Index, and the NTCL prognostic index failed to predict the OS of NUAT-NTCL, but did predict the OS in UAT-NTCL. Independent predictors for OS by multivariate analyses differed between each subset. In the NUAT subset, extranodal sites and regional nodes predicted the OS, while Ann Arbor staging, age, performance status, and lactate dehydrogenase level predicted the OS in the UAT subset.ConclusionNUAT-NTCL may represent a distinctive disease entity in terms of clinical factors, independent predictors, and survival outcomes.     

原发扁桃体非霍奇金淋巴瘤的预后因素

目的：评价原发扁桃体非霍奇金淋巴瘤（NHL）的肿瘤侵犯范围（T分期）和国际预后指数（IPI）的预后价值,并对早期患者提出治疗建议。方法：回顾分析306例原发扁桃体NHL,根据Ann Arbor分期,I期35例,II期178例,Ⅲ期49例,Ⅳ期44例,根据1997年AJCC TNM分期标准,TI 29例,T2 142例,T3 117例,T4 18例,I期单纯放射治疗12例,综合治疗23例,Ⅱ期单纯放射治疗57例,单纯化疗2例,综合治疗119例,Ⅲ,Ⅳ期以化疗为主,结果：T1,T2,T3和T4的5年癌症相关生存率（CSS）分别为73．8％,59．0％,56．5％和26．5％（P＜0．05）,IP1评分0分,1分和2或3分的5年CSS分别为69．9％,49．0％和25．0％（P＜0．01）,II期单纯放疗和综合治疗的5年无瘤生存率（DFS）分别为46．2％和60．4％（P＜0．05）,多因素分析证明,影响预后的因素有一般状态,B症状,Ann Arbor分期,T分期和IPI,结论：原发肿瘤T分期和IPI是扁桃体NHL重要的预后因素,综合治疗改善了II期扁桃体NHL的DFS。     

Clinical Predictors and Prognostic Model for Pediatric Lymphoblastic Lymphoma Treated With Uniform BFM90 Protocol: A Single-Center Experience of 65 Patients From Asia

BackgroundThere is a lack of clinical predictors for prognosticating lymphoblastic lymphoma (LBL). In view of this lacuna, we evaluated outcomes and prognostic factors for LBL treated with a uniform protocol at our center.Patients and MethodsThis study included consecutive patients of pediatric LBL aged ≤18 years from January 2003 to January 2017. Patients were staged using the St Jude staging system. All patients were treated with acute lymphoblastic leukemia like BFM90 protocol. The Kaplan–Meier method was used for survival analysis. A statistical model was made using stepwise regression and forward selection of the factors predicting event-free survival (EFS) and overall survival (OS).ResultsSixty-five patients were evaluated with a median age of 12 years (range, 1-18 years) and male:female ratio of 2.25:1. Fifty-four patients presented with mediastinal disease. Median follow-up was 54.57 months (range, 0.6-140.5 months). EFS at 10 years was 62 ± 6% (95% confidence interval [CI], 0.49-0.73) and OS 71 ± 5% (95% CI, 0.57-0.81). In multivariate analysis, symptom duration ≤30 days, white blood cell (WBC) count >12000/µL and serum albumin ≤3.5 g/dL predicted inferior EFS and OS. A prognostic model with these 3 factors suggested that those without any of these risk factors had an OS of 92 ± 5% whereas those with 2 or 3 factors had an OS of 37 ± 14%.ConclusionOur outcomes are 15% to 20% lower than in the published literature. Low albumin level, high WBC count at baseline, and symptom duration <30 days emerged as adverse predictors for EFS and OS. These clinical predictors and prognostic model for pediatric LBL should be validated in prospective cohorts.     

The incidence and survival outcomes of patients with primary cardiac lymphoma: A SEER-based analysis

This study aimed to evaluate the incidence and prognosis of primary cardiac lymphoma (PCL) by using the Surveillance, Epidemiology, and End Results Program (SEER) database. Patients diagnosed with PCL and the disease incidence in the SEER database from 1975 to 2016 were included. Overall survival (OS) and cause-specific survival (CSS) curves were calculated using the Kaplan-Meier method and compared by the log-rank test. Univariate and multivariable Cox proportional hazard regression analyses were used to identify associations with outcome measures. The incidence of PCL was 0.011/100 000, and a predominance of elderly and male patients was observed. A total of 144 patients were enrolled. The median age of onset was 68 (9-96) years, including 80 (55.6%) males and 64 (44.4%) females. Multivariate analysis revealed that age and chemotherapy were independent prognostic factors for OS (both P < .05). Ann Arbor stage and chemotherapy were independent prognostic factors for CSS (both P < .05). In terms of treatment modality, chemotherapy combined with surgery was an independent protective factor for OS and CSS (both P < .05). For patients with primary cardiac diffuse large B-cell lymphoma (cardiac DLBCL), multivariate analysis also showed that age, Ann Arbor stage, and chemotherapy were all independent prognostic factors for OS and CSS (all P < .05). Chemotherapy combined with surgery was associated with a significant benefit in terms of OS and CSS (both P < .05). Our study confirmed that older age and advanced Ann Arbor stage were independent risk factors for PCL, and treatment with chemotherapy or cooperation with surgery resulted in better long-term survival.     

Rituximab in treatment of primary gastric diffuse large B-cell lymphoma

Abstract In the rituximab era, the optimal treatment modality for primary gastric diffuse large B-cell lymphoma (PG-DLBCL) still remains unclear. We performed a retrospective, multicenter analysis of 65 patients with PG-DLBCL to assess the efficacy and toxicity of the addition of rituximab to conventional chemotherapy. When compared with conventional chemotherapy, there was a trend that rituximab plus chemotherapy yielded a higher complete response rate, 5-year event-free survival (EFS) rate and 5-year overall survival (OS) rate, but this was not statistically significant. In subgroup analysis, better OS was observed only for patients with advanced-stage disease when rituximab was added. When involved-field radiotherapy (IFRT) was included, EFS and OS were significantly prolonged in the conventional chemotherapy group, but not in the immunochemotherapy group. If focusing on patients with localized-stage disease receiving immunochemotherapy, the efficacies of short-course rituximab (R)-chemotherapy plus IFRT and 6-8 courses of R-chemotherapy without IFRT were comparable. In conclusion, it is necessary to carry out prospective randomized trials to help further illuminate the role of rituximab in the PG-DLBCL treatment landscape. If a patient has been treated with a non-rituximab-containing regimen, additional IFRT should be considered, and for patients with advanced-stage disease, rituximab should be considered.     

初次诊断Ⅲ级或伴转化滤泡性淋巴瘤患者预后影响因素分析

目的:探讨初次诊断Ⅲ级或伴转化滤泡性淋巴瘤（follicular lymphoma,FL）患者预后影响因素。方法:回顾性分析我院2011年1月至2018年6月收治初次诊断Ⅲ级或伴转化FL患者共94例临床资料,根据基线临床资料进行随访生存资料亚组分析,采用单因素和多因素法确定预后独立影响因素。结果:全部患者随访3年累积无进展生存（PFS）率和累积总生存（OS）率分别为56.15%,81.79%。不同IPI评分、FLIPI-1评分、FLIPI-2评分、Ann Arbor分期、淋巴结受累部位、直径3 cm以上淋巴结受累部位及结外病变亚组患者随访3年累积PFS率比较差异有统计学意义（P＜0.05）;不同IPI评分、FLIPI-1评分、FLIPI-2评分及LDH水平亚组患者随访3年累积OS率比较差异有统计学意义（P＜0.05）。单因素分析结果显示,Ann Arbor分期Ⅲ-Ⅳ期、淋巴结受累部位≥5个、直径＞3 cm受累淋巴结个数≥3、结外受累部位≥2个、IPI评分2~3分、FLIPI-1评分/FLIPI-2评分≥3分均与初次诊断Ⅲ级或伴转化FL患者PFS有关（P＜0.05）;IPI评分2~3分、FLIPI-2评分≥3分及LDH≥240 IU/mL均与初次诊断Ⅲ级或伴转化FL患者OS有关（P＜0.05）。多因素分析结果显示,IPI评分2~3分是初次诊断Ⅲ级或伴转化FL患者PFS独立影响因素（P＜0.05）;IPI评分2~3分和FLIPI-1评分≥3分均是初次诊断Ⅲ级或伴转化FL患者OS独立影响因素（P＜0.05）。结论:初次诊断Ⅲ级或伴转化FL患者生存获益与IPI评分和FLIPI-2评分独立相关。     

鼻咽非霍奇金淋巴瘤的临床与预后分析

目的 探讨鼻咽非霍奇金淋巴瘤的临床特点、治疗及国际预后指数(IPI)的应用价值。方法 回顾性分析1983—1997年间136例首程治疗的鼻咽非霍奇金淋巴瘤患者的临床资料。按照工作分类原则进行分类,高度恶性18例,中度恶性77例,低度恶性2例,未分类39例。根据Ann Arbor分期,Ⅰ期25例,Ⅱ期91例,Ⅲ期12例,Ⅳ期8例。Ⅰ期单纯放疗13例,综合治疗12例;Ⅱ期单纯放疗31例,综合治疗57例,Ⅲ和Ⅳ期以化疗为主。结果 5年和10年总生存率(OS)、癌症相关生存率(CSS)和无病生存率(OFS)分别为56．2％和48．3％,61．2％和58．0％,51．1％和46．5％。IPI为0,1及2～3分的5年CSS分别为70．9％、44．9％、30．0％(P=0．004)。Ⅰ期化放疗综合治疗和单纯放射治疗的5年CSS分别为82．2％和83．1％,10年CSS分别为82．2％和66．4％,差异无显著性(P=0．779)。Ⅱ期综合治疗和单纯放射治疗5年CSS分别为70．9％和46．0％,10年CSS分别为65．4％和46．0％,差异有显著性(P=0．04)。Cox多因素分析显示,影响预后的因素为Ann Arbor分期、B组症状和IPI。结论 IPI是判断原发于鼻咽非霍奇金淋巴瘤预后的重要指标,Ⅱ期鼻咽非霍奇金淋巴瘤应考虑综合治疗。