全腹腔盆腔照射胃肠道非霍奇金氏淋巴瘤

目的：研究胃肠道非霍奇金淋巴瘤Ⅰ－Ⅱ期患者全腹腔盆腔放疗的近期疗效和急性放射性毒副反应与耐受性。方法：从１９９６年１月－１９９８年１２月我院收治的３５例Ⅰ－Ⅱ期原发性胃肠道非霍奇金氏淋巴瘤患者在手术和化疗后，行全腹腔和盆腔的１８ＭＶ Ｘ线前后大野照射，肿瘤另２０８３－３５２９ ｃＧｙ／１２－２３次／２．４－５．２周，对于原发灶大或化疗后残留灶明显者给予局部加量６００－１５０１ ｃＧｙ／４－８次。结     

胃肠道非霍奇金淋巴瘤的治疗

目的：探讨原发于胃肠道的恶性淋巴瘤（Primary Gastrointestinal Malignant Lymphoma PGIML)治疗方式与疗效的关系。方法：回顾性分析我院1981年5月－1997年5月治疗的52例PGIML的资料，将其分为单纯手术（单术）、手术＋化疗（术化）及手术＋放疗＋化疗（综合）三个组，以kaplan-Meier方法分别统计其1、3、5年生存率，Logrank作显著性检验。结果：单术、术化及综合组实际5年生存率分别为20．0％、60．8％及78．5％，与单术相比有显著性意义（P＜0．05），尤以综合组的疗效最好。说明在PGIML治疗中，放疗是一种有效的手段。结论：PGIML治疗宜采用手术配合放、化疗的综合治疗。     

原发性胃肠道非霍奇金氏淋巴瘤92例预后分析

目的：通过生存曲线及多因素分析,探讨原发性胃肠道淋巴瘤的临床特征与预后的关系。方法：选择我院自１９９０年至１９９６年的原发性胃肠淋巴瘤共９２例,均经病理确诊,并进行了含ＡＤＭ为主方案多程化疗和／或手术切除治疗,同时有良好的随访。结果：Ｋａｐｌａｎ－Ｍｅｉｅｒ生存分析结果,２年的累积生存率为６７．０％,５年的预计累积生存率为５４．３％,平均生存期为５４．８月（９５％可信区间４７．４￣６０．１月）,５     

原发性胃肠道非霍奇金淋巴瘤的治疗

４３例原发性胃肠道非霍奇金淋巴瘤，临床表现均无特异性，术前误诊率高，主要接受单纯手术或手术＋化疗。随访中发现，手术＋化疗组３年、５年生存率分别为７３．９％和６５．２％，而单纯手术组则分别为３８．９％和２７．８％，两组差异有显著性（Ｐ〈０．０５）。笔者认为对本瘤应采取以手术为主的综合治疗，并认为术后正规、系统地化疗将会对本病的治疗发挥更大的作用。     

原发胃肠道非霍奇金淋巴瘤的研究现状

胃肠道是原发结外非霍奇金淋巴瘤（non-Hodgkin's lymphoma,NHL）最常见的发病部位,发病率逐年上升。虽然结内非霍奇金淋巴瘤的治疗模式已标准化,但是对于原发胃肠道非霍奇金淋巴瘤的治疗仍存在争议。手术、化疗、放疗等治疗方式可单独应用,或以不同组合联合应用,最佳治疗模式目前尚无定论,且影响原发胃肠道非霍奇金淋巴瘤预后的因素较多。现对原发胃肠道非霍奇金淋巴瘤的发病率、临床特点、组织学分类、治疗方案及预后进行综述,重点探讨该病的治疗及预后。     

原发性胃肠道非霍奇金淋巴瘤25例分析

目的 对原发性胃肠道非霍奇金淋巴瘤(PGIL)的临床特征、诊治及预后进行探讨.方法 回顾性分析25例PGIL的临床资料、病理类型;按上述变量分组,分别统计其3年及5年生存率,探讨各变量与生存率之间的关系.结果 本组病例均随访5年以上,3年和5年总生存率分别为56%(14/25),36%(9/25).3年和5年生存率:Ⅰ、Ⅱ期患者为76.9%(10/13)、61.5%(8/13),Ⅲ、Ⅳ期患者为33.3%(4/12)、8.3%(1/12)(P<0.05).血清乳酸脱氢酶(LDH)<245 u/L为75%(12/16)、56%(9/16),LDH>245 u/L者为22.2%(2/9)、0(0/9)(P<0.05).低度恶性为73.3%(11/15)、53.3%(8/15),中高度恶性为30%(3/10)、10%(1/10)(P<0.05).B细胞型PGIL为72.2%(13/18)、50%(9/18),而T细胞型PGIL为14.3%(1/7)、0(0/7)(P<0.05).结论 临床分期、血清乳酸脱氢酶高低、病理及免疫表型为影响PGIL预后的重要因素.     

原发胃肠道非霍奇金淋巴瘤治疗进展

 胃肠道是原发结外非霍奇金淋巴瘤（NHL）最常见的侵犯部位。与原发结内的NHL相比,原发胃肠道非霍奇金淋巴瘤（PGI-NHL）的治疗有很大的特殊性。目前对于弥漫型病变首选联合化疗,手术仅被用于病变的局部控制预防和治疗局部并发症,放射治疗被用于残留病变的清除及严重的局部病变。对于幽门螺杆菌阳性的患者,均应进行抗幽门螺杆菌的治疗。针对PGI-NHL的治疗方法及进展进行综述。     

原发性胃肠道非霍奇金淋巴瘤的临床特征及疗效分析

背景与目的:原发性胃肠道淋巴瘤是来源于结外淋巴组织的非霍奇金淋巴瘤(non-Hodgkinslymphoma,NHL),具有独特的临床病理特征。本文报告原发性胃肠道淋巴瘤的临床病理特征及其治疗效果。方法:回顾性分析我院1994年1月至2000年6月收治的经病理检查证实的22例原发性胃肠道淋巴瘤患者的病例资料。结果:本研究所有病例均随访3年以上,随访5年以上13例,3、5年生存率分别为45.5%(10/22)、38.5%(5/13);随着临床分期增高,3、5年生存率降低;低度恶性边缘带粘膜相关淋巴组织淋巴瘤较其它病理类型预后为佳;16例治疗后达到完全缓解者,3、5年生存率分别为62.5%(10/16)、45.5%(5/11),而6例原发灶未控者3年生存率为0,有显著性差异(P<0.05);12例单纯手术治疗者3、5年生存率分别为33.3%(4/12)、10%(1/10),6例手术联合化、放疗者(5例手术后辅助化疗,1例手术后行全腹照射)的3、5年生存率分别为83.3%(5/6)、66.7%(2/3)。结论:原发性胃肠道淋巴瘤应以综合治疗为主,原发灶未控可影响预后。     

原发性胃肠道非霍奇金淋巴瘤16例

目的 探讨胃肠道非霍奇金淋巴瘤(PGIL)的临床特征、诊治及预后.方法 对临床与病理确诊的16例PGIL作回顾性分析.结果 经内窥镜、手术、病理及免疫组化诊断胃黏膜相关组织(MALT)淋巴瘤4例,其中幽门螺旋菌(HP)阳性者3例;弥漫性大B细胞淋巴瘤(DLBCL)5例;回盲部DLBCL2例;回盲部外周T细胞淋巴瘤2例;结肠外周T细胞淋巴瘤2例;结肠DLBCL 1例.治疗后CR 6例、PR 4例、NR 6例,有效率62.25%.结论 PGIL的临床表现较为复杂,多呈非特异性症状,易发生误诊.     

原发性胃肠道非霍奇金淋巴瘤的临床研究

目的：回顾性分析原发性胃肠道非霍奇金淋巴瘤（PGI NHL）的形态学和病理类型、临床特征、治疗及预后。方法：收集病理确诊的原发性胃肠道非霍奇金淋巴瘤89例，行常规病理和免疫组化染色（CD3、CD5、CD7、CD10、CD20、CD23、CD45RO、Kappa、Lambda、Cyclin D1、Ki-67），按照WHO分类方法重新分类，借以探讨其临床特征。结果：①ⅠE期24例，ⅡE期33例，ⅢE期19例，ⅣE期13例。②T细胞性和B细胞性PGI NHL各17例和72例。③MALT淋巴瘤共15例，其中胃MALT瘤14例，小肠1例。④3、5年总生存率直接法计算分别为77.0%（57/74）和53.6（30/56）。其中ⅠE期24例，3、5年总生存率分别为100%（19/19）和85.7%（12/14），ⅡE期33例，3、5总生存率分别为85.2%（23/27）和65%（13/20），ⅢE期19例，3、5年总生存率分别为58.8%（10/17）和30.8%(4/13),ⅣE期13例，3、5年总生存率分别为45.5%（5/11）和11.1%(1/9)。结论：PGI NHL临床表现无特异性，容易延误诊断；胃癌发生率最高，临床分期以ⅠE、ⅡE期为主，病理分型以中度恶性和B细胞性为主，ⅠE期和ⅡE期临床预后明显比ⅢE期好，B细胞性临床预后较T细胞性好；根治性手术和术后正规化疗，必要时加用放疗是取得长期生存的重要措施。     

A clinicopathological study of primary gastrointestinal lymphoma

A retrospective analysis of 48 cases of histologically proven primary gastrointestinal lymphoma was done. The analysis covered a 12-year period from January 1966 through December 1977. Four percent of all malignant tumors of the gastrointestinal tract were of this type. Males outnumbered females by a ratio of 1.8:1. The mean age of the patients was 21 years. The vagueness and variability of clinical features and nonspecific radiological findings were the main reasons for subjecting all the patients in this series to laparotomy. The most common site of involvement was the ileocecal region, followed by the ileum, the jejunum, and the stomach. Most of the cases were in an advanced stage of the disease as was suggested by the finding of lump in 60% and ascites in 20% of the cases. Radical resection, possible in only six cases, appears to be the best treatment. The effectiveness of radiotherapy and chemotherapy were disappointing. Prognostically, cases of localized and polypoidal lesions of the small bowel and Hodgkin lymphoma showed better survival.     

细胞图像形态的分形维研究

本文简述了分形及分形维的概念,针对分形在细胞图像形态测量中的应用,对细胞轮廓线盒维的计算模型建立进行了讨论,并将该模型用于测定具有多层细节的二维细胞图像的分形维数,验证了论文中提出的盒维计算模型。     

脑原发性淋巴瘤免疫组化及形态定量研究

对 7例原发性中枢神经系统淋巴瘤 (Primarycentralnervoussystemlymphoma ,PCNSL)进行免疫组化及病理形态定量研究。方法　对瘤组织采用常规石蜡包埋切片、HE染色及LSAB免疫组化染色 ,光镜观察。另选取病变典型的切片应用HPIAS - 10 0 0彩色图像分析系统对肿瘤细胞核的形态进行定量测定。结果　 7例均为B细胞淋巴瘤 ,共中大裂 -无裂细胞型 4例 ,小淋巴细胞型 2例 ,小裂细胞型 1例。各型淋巴瘤与对照组之间除椭圆度外 ,其余形态学参数均有非常显著性差异 (P <0 .0 0 1)。 3组淋巴瘤两两间比较显示大裂 -无裂细胞型与小裂细胞型、大裂 -无裂细胞型与小淋巴细胞型除个别指标、多数参数两两间有非常显著性 (P <0 .0 0 1)或显著性差异 (P <0 .0 5) ;小淋巴细胞型与小裂细胞型间 ,面积等效体积、等效圆直径、长径、短径、形状因子、矩形度、实面积 7项参数有显著性差异。其余 8项参数无显著性差异。结论　采用形态定量的方法能对PCNSL做出准确的诊断 ,对于PCNSL的某些组织学分型能够提供客观的、准确的和定量的依据 ,因而具有十分重要的意义。     

30例睾丸原发非霍奇金淋巴瘤回顾性临床分析

目的：睾丸淋巴瘤是睾丸肿瘤中较少见的类型，而原发睾丸的淋巴瘤在淋巴瘤中也较罕见。本文旨在对我院睾丸原发恶性淋巴瘤的临床病理特征和治疗情况进行分析，同时对最近的相关报道进行文献复习。方法：分析1990年到2005年就诊并有完整随访的睾丸原发淋巴瘤患者共30例。结果：30例患者中位年龄57．5（3～79）岁，原发单侧者25例，原发双侧者5例，ⅠE期及ⅡE期的患者占86．7％，弥漫大B细胞淋巴瘤23例（76．7％），外周T细胞性淋巴瘤4例（13.3％）。所有患者均接受睾丸切除术，23例患者术后接受了CHOP或类似方案化疗。8例患者在化疗后接受了放射治疗，其中5例患者行阴囊和对侧睾丸放疗，21例患者在首次治疗后取得CR／CRu．3例患者PR。中位随访27．9个月，全组患者的5年OS和PFS分别是42.3％和30.3％。单因素分析显示病理类型和IPI评分对预后有影响：结论：睾丸原发非霍奇金氏淋巴瘤应采取综合治疗，术后给予蒽环类药物为主的全身化疗．中枢预防和对侧睾丸的放射治疗有助于减少复发。     

A retrospective international study on primary extranodal marginal zone lymphoma of the lung (BALT lymphoma) on behalf of International Extranodal Lymphoma Study Group (IELSG)

Primary lymphoma of the lung is a rare entity. Clinical features, optimal treatment, role of surgery and outcomes are not well defined, and the follow‐up is variable in published data. Clinical data of 205 patients who were confirmed to have bronchus mucosa‐associated lymphoid tissue lymphoma from December 1986 to December 2011 in 17 different centres worldwide were evaluated. Fifty‐five per cent of the patients were female. The median age at diagnosis was 62 (range 28–88) years. Only 9% had a history of exposure to toxic substances, while about 45% of the patients had a history of smoking. Ten per cent of the patients had autoimmune disease at presentation, and 19% patients had a reported preexisting lung disease. Treatment modalities included surgery alone in 63 patients (30%), radiotherapy in 3 (2%), antibiotics in 1 (1%) and systemic treatment in 128 (62%). Patients receiving a local approach, mainly surgical resection, experienced significantly improved progression‐free survival (p = 0.003) versus those receiving a systemic treatment. There were no other significant differences among treatment modalities. The survival data confirm the indolent nature of the disease. Local therapy (surgery or radiotherapy) results in long‐term disease‐free survival for patients with localized disease. Systemic treatment, including alkylating‐containing regimens, can be reserved to patients in relapse after incomplete surgical excision or for patients with advanced disease. Copyright © 2015 John Wiley & Sons, Ltd.     

Non-Hodgkin's lymphoma in Northern Israel: A study of 481 patients with emphasis on ethnic-related patterns

During the period between 1970-1984, 481 patients with previously untreated non-Hodgkin's lymphoma were referred to the Northern Israel Oncology Center, Haifa. There were 264 (54.9%) Ashkenazi Jews, 123 (25.6%) non-Ashkenazi Jews, and 86 (17.9%) Arabs. The mean age at diagnosis was 60 ± 15 years for Ashkenazi Jews, 45 ± 22 years for non-Ashkenazi Jews, and 36 ± 22 years for Arabs. Ashkenazi Jews had a higher rate of nodular lymphoma compared to non-Ashkenazi Jews and Arabs. Extranodal lymphoma occurred more frequently in non-Ashkenazi Jews and Arabs. Lymphoma of the small intestine was more common in Arabs than in Ashkenazi and non-Ashkenazi Jews. Despite these differences in the pattern of disease, 5 year actuarial survival figures for the various ethnic groups were similar.     

A case of large cell CNS lymphoma associated with a systemic small cell lymphocytic lymphoma

Summary A case is reported of a 59 y/o woman with a large cell CNS lymphoma and a small cell lymphocytic lymphoma in the bone marrow. The brain tumor underwent spontaneous regression and subsequent regrowth while there was slow progression of the systemic small cell lymphoma. The CNS lymphoma regressed rapidly following treatment with prednisone and cyclophosphamide. We hypothesize that the small cell lymphoma in this patient may represent an underlying immunodeficiency disorder. Dr. Weissman is a recipient of an American Cancer Society Career Development Award.     

Peripheral T-cell lymphoma: a clinicopathologic study of 42 cases

We analysed the clinical and pathologic features of 42 patients with immunologically confirmed peripheral T-cell lymphoma. The median age was 60 years and the male to female ratio was 1:1. A prior lymphoproliferative or autoimmune disorder was present in 14 per cent of the patients. Signs of advanced disease were usually present from the onset, such as B symptoms (55 per cent), generalized lymphadenopathy (57 per cent), stage III/IV disease (62 per cent), and elevated levels of serum lactate dehydrogenase (68 per cent). Primary extranodal disease (14 per cent), hepatomegaly (12 per cent), splenomegaly (12 per cent), lung/pleural involvement (12 per cent), skin involvement (21 per cent), and bone marrow involvement (28 per cent) were uncommon. Lymphocytopenia was present in 64 per cent of the patients, and none of nine patients tested were serologically positive for human T-cell leukemia/lymphoma virus (HTLV-I) infection. Among 38 patients receiving combination chemotherapy, 20 (53 per cent) achieved a complete remission. The actuarial median survival of all patients was 17 months. Age greater than 60 years and stage III/IV disease predicted a poor clinical outcome, whereas the large cell histological subtype predicted a favourable outcome. Prospective clinical studies using uniform treatments and a uniform histologic classification scheme are needed to confirm these findings.     

皮下脂膜炎样T细胞淋巴瘤六例临床及病理特点分析

目的 皮下脂膜炎样T细胞淋巴瘤(subcutaneous pannieulitis-like T cell lymphoma,SPTCL)是一类非常罕见的皮肤T细胞恶性淋巴瘤,相关报道较少且易误诊.本研究旨在分析SPTCL患者的临床及病理特征.方法 回顾性分析2010-01-01-2015-12-31天津医科大学肿瘤医院收治的6例SPTCL患者的临床治疗、预后及病理特征.结果 6例SPTCL患者中,男3例,女3例.6例患者的年龄2～53岁,平均诊断年龄为29岁,其中4例的患者＜30岁.起病部位主要为四肢,5例患者表现为皮下的硬结肿物,1例患者表现为皮肤溃疡和渗出.皮肤损害出现的中位时间为13个月(1～60个月).6例患者中无伴发嗜血细胞综合症(hemophagocytic syndrome,HPS)者.6例患者镜下共同特征是小或中等大小的不典型肿瘤细胞围绕脂肪细胞生长.免疫组化特征为CD3+(100％)、CD4+ (100％)、CD8+(100％)、CD20-(100％)、CD56-(83％)、TCRβF-1+ (100％)、TIA-1+ (100％)、GrB+ (100％)、穿孔素阳性(100％).6例SPTCL患者均接受了以CHOP或CHOP样方案为主的多药联合化疗,化疗后3例患者获得CR,2例患者PR,1例患者SD.CR的3例患者中有2例患者出现复发,其中1例患者经自体造血干细胞移植后获得CR,1例在间断化疗状态下维持SD.获得PR的1例患者经自体造血干细胞移植后获得CR.中位随访时间为47个月(7～73个月),1例失访,3例患者无病生存,2例患者带瘤生存.结论 本研究SPTCL患者呈惰性进展且预后较好,常用的化疗方案为CHOP或CHOP样方案,早期复发或化疗效果欠佳的患者采取自体造血干细胞移植可能获益.