非霍奇金淋巴瘤的多药耐药性

非霍奇金淋巴瘤的多药耐药性是非霍奇金淋巴瘤治疗失败的重要因素,寻找合理的化疗药物是治疗非霍奇金淋巴瘤的关键。本文就目前非霍奇金淋巴瘤的多药耐药机制作一综述。     

EMCOP方案治疗非霍奇金淋巴瘤30例临床分析

目的：探讨EMCOP方案治疗非霍奇金淋巴瘤的临床疗效。方法：应用EMCOP联合化疗方案（VP－16、MTN、CTX、VCR、Pred）治疗非霍奇金淋巴瘤患者30例。其中，初治24例，复治6例。并对药物毒副反应及影响疗效因素进行分析。结果：30例非霍奇金淋巴瘤患者完全缓解率66．7％，部分缓解率23.3％，总有效率90．0％，2年生存率53．3％。结论：EMCOP方案为治疗非霍奇金淋巴瘤较理想化疗方案，本组病例中无论初治或复治者疗效优于CHOP方案。     

美罗华治疗恶性淋巴瘤1例临床观察

恶性淋巴瘤是一种来源于淋巴造血组织的实体瘤。由于其病因尚未明确，目前在治疗上较为复杂。美罗华是治疗复发或化疗抵抗的CD20阳性的非霍奇金淋巴瘤的高效新药，它能准确识别和清除人体的肿瘤细胞。美罗华还能促进淋巴瘤细胞的死亡，抑制肿瘤细胞的增殖，使已经耐药的肿瘤细胞对化疗药物重新敏感。现对我科应用美罗华治疗恶性淋巴瘤1例患的临床观察总结如下：     

非霍奇金淋巴瘤合并乳糜胸3例临床分析

目的探讨非霍奇金淋巴瘤合并乳糜胸的临床特点及疗效。方法回顾性分析2006年1月～2008年4月收治的3例非霍奇金淋巴瘤合并乳糜胸的临床资料。结果非霍奇金淋巴瘤合并乳糜胸主要在化疗过程出现，患者表现为进行性呼吸困难及胸痛，3例患者均为非霍奇金淋巴瘤，为大B细胞淋巴瘤，对化疗敏感，但很快复发。结论恶性淋巴瘤合并胸腔积液预后差，宜采取包括干细胞移植在内的综合治疗。     

恶性肿瘤并上腔静脉阻塞综合征102例临床分析

目的：探讨恶性肿瘤并上腔静脉阻塞综合征的最佳治疗方式。方法：对102例恶性肿瘤合并上腔静脉阻塞综合征（SVCS）进行回顾性分析，将102例患者分为两组。57例接受化疗（包括40例肺癌、4例恶性胸腺和13例非霍奇金淋巴瘤）．45例患者接受放疗（包括32例肺癌、4例恶性胸腺瘤和9例非霍奇金淋巴瘤）。小细胞肺癌的化疗采用EP方案．非小细胞肺癌采用NP方案，非霍奇金淋巴瘤采用CHOP方案，恶性胸腺瘤采用PAC／EP方案；放疗采用大剂量冲击照射，3～4d后改用常规剂量。结果：放疗组总缓解率（93．4％）高于化疗组（78．9％）（P〈0．05）。治疗第3天，放疗组的缓解率高于化疗组，第21天化疗组和放疗组缓解率相差不大。放疗组非小细胞肺癌缓解率为90．0％，小细胞肺癌为95．5％，恶性胸腺瘤为100％，非霍奇金淋巴瘤为88．9％；化疗组非小细胞肺癌缓解率为60％，小细胞肺癌缓鹪率为92．0％，恶性胸腺瘤为50．0％，非霍奇金淋巴瘤为84．6％。结论：放疗组获得缓解的时间短于化疗组，而对于小细胞肺癌和非霍奇金淋巴瘤，化疗组与放疗组疗效差异无统计学意义。     

原发睾丸非霍奇金淋巴瘤15例临床分析

【目的】研究原发睾丸非霍奇金淋巴瘤的临床病理特点和治疗情况，探讨该病最佳的治疗方式。【方法】1980—2003年间，原发睾丸非霍奇金淋巴瘤共15例，分析其临床和病理特点，总结其疗效。【结果】15例原发睾丸非霍奇金淋巴瘤患，33—77岁，中位年龄51岁，均以睾丸无痛性肿大为首发症状，ⅠE期8例(53．3％)，ⅡE期6例(40％)，ⅢE期0例，ⅣE期1例(6．7％)，B细胞来源11例(73．3％)，T细胞来源3例(20％)，分类不明1例，全部患均接受经腹股沟精索高位结扎睾丸根治性切除术，14例手术后均接受化疗或放疗，中位生存期20月，全组1、3、5年生存率分别为89．5％、74．8％、59．65％。【结论】原发睾丸非霍奇金淋巴瘤在行睾丸切除术后应给予放化综合治疗，建议术后给予CHOP方案(有条件的病人可给予Rituximab CHOP方案)、预防性鞘内化疗、对侧睾丸预防性放射，以进一步提高疗效。     

CHOP方案化疗中晚期非霍奇金淋巴瘤98例分析

目的：探讨中晚期非霍奇金淋巴瘤化疗的疗效和副作用。方法：对98例中晚期非霍奇金淋巴瘤患者以CHOP方案化疗，其中43例首程化疗后加局部放疗，观察其近期疗效和生存期。结果：首程化疗后总缓解率为81．6％，完全缓解率为33．7％，加用放疗后完全缓解增加9例，总完全缓解率为42．9％。全组1、3、5年存活率分别为68．8％、40．0％、19．8％。平均生存时间为2．0年。主要副作用为轻、中度消化道反应和骨髓抑制。结论：CHOP方案作为目前治疗非霍奇金淋巴瘤的经典方案，疗效确切，但对肿块巨大或侵及韦氏环者必须辅以局部化疗，才能提高其疗效。     

表柔比星与多柔比星治疗老年非霍奇金淋巴瘤对比观察

目的：探讨表柔比星与多柔比星治疗老年非霍奇金淋巴瘤的疗效。方法：将27例老年非霍奇金淋巴瘤病人随机分为2组，分别使用以表柔比星和多柔比星为主的化疗方案。结果：表柔比星组和多柔比星组总有效率相似，但表柔比星毒副作用轻。结论：老年非霍奇金淋巴瘤病人的化疗中，表柔比星是一个值得推广应用的药物。     

难治性非霍奇金淋巴瘤的治疗进展

淋巴瘤是一组异质性疾病，包括霍奇金淋巴瘤（Hodgkin’slymphoma，HI。）和非霍奇金淋巴瘤（non—Hodgkin’Slymphoma，NHL），各亚型的细胞遗传学和分子生物学、临床表现、治疗疗效以及疾病转归有较大的差异。部分在初治时即表现为对化疗耐药，即化疗2个周期以上无效或退缩后很快复发，被称为难治性淋巴瘤。目前尚缺乏统一的确切定义，通常情况下指的是后者。     

原发性肾非霍奇金淋巴瘤临床分析

目的 探讨原发性肾非霍奇金淋巴瘤的临床特征。方法 分析2例原发性肾非霍奇金淋巴瘤病例资料，并进行组织形态学观察和免疫组织化学检测。结果 2例患者诊断为原发性肾非霍奇金淋巴瘤，临床上无特异性，1例患者死亡，1例术后行化疗联合放疗后病情好转。结论 原发性肾非霍奇金淋巴瘤是一种罕见的、恶性程度较高的肿瘤，诊断依赖于组织病理学及免疫组织化学标记检查。术前确诊原发性肾非霍奇金淋巴瘤可避免手术，联合化疗和放疗应为治疗首选。     

Primary malignant lymphoma of the gastro-intestinal tract: a clinicopathological study of 24 cases.

Twenty-four cases of primary lymphoma of the gastro-intestinal tract were diagnosed during the period 1970 to 1991. There was a preponderance of males and the male to female ratio being 1.4:1. Age ranged from 9-70 years, mean 32.2 years. Small intestine was involved in 50% cases, large bowel in 9 cases (37.5%) and stomach in 3 cases (12.5%). There were 5 cases (20.8%) of Hodgkin's disease and 19 cases (79.2%) were of non-Hodgkin's lymphoma. All cases of gastric lymphoma complained of epigastric pain, weight loss and vomiting. In lymphoma of small intestine, 8 patients complained of pain associated with vomiting and 6 patients complained of distension of abdomen. In large bowel lymphoma, pain in right iliac fossa was complained by 4 patients and bleeding per rectum by 3 patients. Out of all the 24 cases, changes in bowel habit were noted in 15 patients and occult blood was positive in 13 cases. Palpable abdominal mass was noted in 14 patients. Histomorphologically, all the 3 cases in the stomach were of lymphocytic lymphoma diffuse type. Out of 19 non-Hodgkin's lymphoma, 15 were of lymphocytic lymphoma and 4 were of histiocytic lymphoma.     

反应停联合化疗治疗中高恶度非霍奇金淋巴瘤的临床疗效观察

目的探讨反应停联合化疗治疗中高恶度非霍奇金淋巴瘤的疗效。方法采用反应停联合化疗治疗30例中高恶度非霍奇金淋巴瘤,初发患者22例,复发患者8例。其中:中恶度24例,18例为初发患者,复发性6例;高恶度6例,4例为初发患者,2例为复发患者。结果:23例达完全缓解(CR76.7%,其中初发患者19例,复发4例),4例部分缓解(PR13.3%,其中初发患者2例,复发2例),总有效率为90%。结果到目前为止生存时间最长达13个月(2例),仍处于CR期。毒副作用主要为消化道症状、轻度肝功能异常以及骨髓抑制。结论反应停联合化疗治疗中高恶度非霍奇金淋巴瘤患者效果好,毒副作用较轻,值得推广使用。     

DICE方案治疗难治性或复发性NHL

目的观察DICE方案治疗难治或复发性非霍奇金淋巴瘤（NHL）的疗效及不良反应。方法采用地塞米松、异环磷酰胺、美安及顺铂联合治疗21例NHL观察其治疗及不良反应。结果21例中，完全缓解（CR）7例，部分缓解（PR）7例，有效率（RR）66．7％。复发组13例中CR6例、PR5例、RR84.6％，明显高于对照组8例中的1例、2例及37．5％，均P〈0.01。DICE方案的主要不良反应表现为骨髓抑制，恶心呕吐和脱发，患者均可耐受。结论DICE方案治疗复发性NHL比难治性疗效好，提示复发和难治性NHL可能有不同的生物学行为，两者应选择不同的治疗方案。     

Primary testicular non-Hodgkin's lymphoma--a review article.

Primary testicular non-Hodgkin's lymphoma was first described as a clinical entity in 1866. It is a rare disease and accounts for 1% of all non-Hodgkin's lymphoma, 2% of all extranodal lymphomas and 5% of all testicular neoplasms. It is the most common testicular tumor in males between sixty and eighty years of age. Testicular non-Hodgkin's lymphoma is unique in its high incidence of bilateral involvement (8-38%), and it is also the most common bilateral testicular tumor. Testicular non-Hodgkin's lymphoma has a predilection for spreading to non-contiguous extranodal sites, especially the central nervous system. Advanced-stage disease is usually managed with doxorubicin-based chemotherapy. For early-stage disease, opinion is divided regarding systemic chemotherapy following orchidectomy. The high incidence of spreading, especially to the central nervous system, leads to advocacy of the use of central nervous system prophylaxis with intrathecal chemotherapy. Prospective multicenter trials incorporating a large number of patients may lead to better guidelines for optimal management of this subtype of non-Hodgkin's lymphoma.     

38例非霍奇金淋巴瘤并发白血病临床分析

目的:探讨非霍奇金淋巴瘤并发白血病的临床特点、诊断及治疗。方法:分析38例非霍奇金淋巴瘤并发白血病的临床资料。结果:38例非霍奇金淋巴瘤性白血病患者主要表现为发热、贫血、出血、淋巴结无痛性肿大、肝脾肿大。恶性淋巴瘤患者出现上述症状及体征伴白细胞增高或减少、血小板下降时,应高度警惕白血病的发生,要尽早作骨髓检查,力争早期诊断,以防漏诊。结论:非霍奇金淋巴瘤性白血病晚期,病情发展迅速,生存期短,应进一步探索更佳治疗方案,以提高疗效。     

Pulmonary infiltrates--diagnostic problems in lymphoma

The use of invasive investigations in immunocompromised patients with pulmonary infiltrates is controversial. We report a series of 22 pulmonary lesions occurring in 19 patients with underlying Hodgkin's (7) and non-Hodgkin's (12) lymphoma in whom invasive investigations were performed. The principle techniques used were fibreoptic bronchoscopy, bronchoalveolar lavage and transbronchial lung biopsy. A specific diagnosis was made on 12 occasions (55%). Involvement of the lung with lymphoma (6) and cytotoxic drug induced pneumonitis (4) were the commonest diagnoses, infection being found on only one occasion. In 15 of these 22 procedures (68%) the information obtained made a positive contribution to patient management.     

胃非霍奇金淋巴瘤患者幽门螺杆菌检测方法比较

目的比较尿素氮呼气试验和粪便抗原检测胃非霍奇金淋巴瘤患者幽门螺杆菌感染的准确性。方法以病理检测结果为对照,对25例确诊胃非霍奇金淋巴瘤患者分别进行尿素氮呼气试验和粪便抗原检测幽门螺杆菌,比较两者检出的准确度。结果粪便抗原检测敏感性81．3％,特异性88．9％,阳性预测值92．9％,阴性预测值72．7％,准确度84％。尿素氮呼气试验敏感度93．8％,特异度100％,阳性预测值100％,阴性预测值90％,准确度：96％。结论尿素氮呼气试验对幽门螺杆菌检测的准确性高于粪便抗原检测。     

Non-Hodgkin's lymphoma of bone causing avascular necrosis of the femoral head

A 14 year old boy presented with a painful hip, initially attributed to Perthes' disease although it is uncommon in teenagers. Subsequent investigation showed that the underlying pathology was non-Hodgkin's lymphoma.     

卵巢原发非霍奇金淋巴瘤的临床病理分析

目的观察卵巢原发非霍奇金淋巴瘤的临床病理表现,探讨该类肿瘤的临床病理特征及病理诊断。方法对15例卵巢原发非霍奇金淋巴瘤作临床病理观察及随访,按WHO关于淋巴造血组织肿瘤分类（2001）进行组织学分型和诊断。采用SP法进行免疫表型检测。结果该类肿瘤占同期收治的非霍奇金淋巴瘤的0．56%（15／2679）,其中,临床Ⅲ期或Ⅳ期者有12例（80%）,临床Ⅰ期或Ⅱ期者3例（20%）。组织学分型：15例（100％）均为弥漫大B细胞淋巴瘤,中心母细胞性或免疫母细胞性。所有病例均接受了手术治疗,3例术后分别用CHOP或COMP方案治疗。4例有随访资料者均死亡,生存时间为21d～18月。结论卵巢原发非霍奇金淋巴瘤少见,预后差。肿瘤的确诊依赖病理学检查和免疫表型检测。     

Non Burkitt's non-Hodgkin's lymphoma in Ile-Ife

To determine the frequency, age and sex patterns of non-Burkitt's non-Hodgkin's lymphoma among cases of lymphoma seen at the histopathology department of the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria. The records of patients with histologically diagnosed non-Burkitt's non-Hodgkin's lymphoma seen over a period of five years were studied. The classification was based on the Working Formulation. The sex and the age at diagnosis as well as the sites of the lesions were noted. Of the fifty three cases of non-Burkitt's non-Hodgkin's lymphoma seen during the study period 54.7% had intermediate grade tumours; 24.5% has low grade and 20.8% had high grade tumours. 92.5% of the cases occurred in adults over the age of 20 years. There was also a male predominance. Nodal as well as extranodal sites were involved and peripheral lymph node involvement most often affected the cervical group of lymph nodes. The results showed that non-Burkitt's non-Hodgkin's lymphoma is predominantly a disease of adults which more often affected males than females. The intermediate grade type with the possibility of cure is the type most often seen in this study. Therefore, early diagnosis and preventive measures against known risk factors in our environment, where possible, are strongly recommended.