以深静脉血栓为首发表现的非霍奇金淋巴瘤二例并文献复习

 目的 提高对非霍奇金淋巴瘤（NHL）伴深静脉血栓（DVT）形成的认识,减少临床漏诊、误诊,增加预防意识。方法 通过二例病例并结合文献复习,对该病的发生率、发病机制、治疗以及预防进行讨论和分析。结果 二例NHL均以下肢浮肿为首发症状,经淋巴结病理确诊为滤泡型淋巴瘤（B细胞来源）,Ann Arbor分期为Ⅳb;超声确诊静脉栓塞（DVT）。接受化疗及抗凝的组合疗法后,1例获得完全缓解（CR）,1例部分缓解（PR）,DVT均消失。结论 DVT可为NHL的首发表现,并可出现于淋巴结肿大前数月,而且NHL伴DVT形成的发生率较低,临床上极易漏诊、误诊。发病机制尚不明确。治疗方法主要为化疗的同时加用抗凝治疗。     

E（M）COP化疗方案治疗非何杰金淋巴瘤疗效分析

目的：探讨足叶乙甙或米托蒽醌联合化疗方案治疗非何杰金淋巴瘤的治疗效果。方法：应用ECOP方案（足叶乙甙,环磷酰胺,长春新碱,强的松）或MCOP方案（米托蒽醌,环磷酰胺,长春新碱,强的松）治疗23例非何杰金淋巴瘤,其中ⅡA2例,ⅢA3例,ⅢB3例,ⅣA4例,ⅣB11例,18例为初治病人,5例为复发病例。结果：全组完全缓解率（CR）13例占56．5％;部分缓解（PR）4例占17．4％,冲刷 有效率73．9％,其中初治18例,总有效率77．8％,复发5例,总有效率60％,ECOP方案治疗16例,CR率为56．5％（9／16）,PR为18．8％（3／16）,总有效率73．3％,MCOP方案治疗7例,CR率为57．1％（4／7）,部分缓解率14．3％（1／17）,总有效率71．4％,上述方案毒副作用有胃肠道反应,骨髓抑制,所有病例血象经间歇期应用或无G－CSF治疗均能恢复。结论：ECOP或MCOP方案是治疗非何杰金淋巴瘤有效而较安全的方案。     

A comparative study of proliferation-associated parameters in B-cell non-Hodgkin lymphoma.

The prognostic value of three proliferation-associated parameters, the frequency of cells in S-phase, mitotic index (MI) and serum deoxythymidine kinase levels (S-TK), was examined in 106 primary cases of B-cell non-Hodgkin lymphomas (NHL), 76 'low grade' NHL and 30 'high grade' NHL and compared with morphology and clinical variables. All three proliferation factors displayed large differences in the mean values of the two groups 'low grade' and 'high grade' NHL, and all revealed significant prognostic information. In 'low grade' NHL, the information decreased with follow-up time. A correlation (r = 0.7) was noted between S-phase values and MI but not between S-TK and the two others. In the entire patient material and in the two prognostic groups defined by morphology, S-TK gave the best prognostic information. MI gave better prognostic information than S-phase values in the whole material and in 'low grade' NHL, whereas the reverse appeared to be true for 'high grade' NHL. In the multivariate analyses, no other parameter apart from S-TK provided any further prognostic importance in the cases of 'high grade' NHL, whereas in that of 'low grade' NHL, MI, stage, age and histology had independent importance.     

应用CHEP/BOD方案治疗晚期中、高度恶性非何杰金氏淋巴瘤的疗效观察

本文报告应用CTX,ADM,VP—16,prednisone,BLM—A5,VCR,Dxame—thesone(CHEP/BOD)治疗23例Ⅲ、Ⅳ期中、高度恶性非何杰金氏淋巴瘤。所有病例均经病理学证实。按“工作规范”分类,中度恶性10例,高度恶性13例。全组共用119个疗程,平均每例用5.2个疗程。治疗结果:全组总缓解率87％。CR率78.3％。15例初治病例的CR率93.3％,8例复治病例的CR率50％。达CR的18例中,4例在2年内复发。主要毒副反应为消化道反应、白细胞降低及脱发。无致死性毒副反应发生。     

骨原发性非霍奇金淋巴瘤X线及CT征象分析

目的 :研究分析骨原发性非霍奇金淋巴瘤的X线及CT征象。方法 :回顾性分析 15例经临床及病理证实的骨原发性非霍奇金淋巴瘤的X线及CT表现。结果 :15例中单发骨灶 13例 ,多发 2例 ;病变位于长骨 9例次 ,扁骨及异形骨 8例次。X线及CT表现为浸润型改变者 8例次、溶骨型 6例次、硬化型 2例次、囊状膨胀型 1例次 ;所有病例可见软组织肿块 ;4例见骨膜反应 ;5例合并病理性骨折。结论 :本病常侵犯单骨 ,多表现为虫蚀样浸润性和溶骨性骨破坏 ,部分病变周边有硬化或有软组织肿块。X线及CT定性诊断困难 ,确诊需结合临床及病理。     

Occupational exposure to ionizing and non-ionizing radiation and risk of non-Hodgkin lymphoma

Objective To investigate the association between occupational exposure to ionizing, ultraviolet (UV), radiofrequency (RF) and extremely low frequency (ELF) radiation and risk of developing non-Hodgkin lymphoma (NHL) in a population-based case-control study. Methods The study population consisted of 694 NHL cases, first diagnosed between 1 January 2000 and 31 August 2001, and 694 controls from two regions in Australia, matched by age, sex and region of residence. A detailed occupation history was first obtained using a lifetime calendar and a telephone interview. Exposure to radiation was then assessed using a Finnish job-exposure matrix (FINJEM). Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated from logistic regression models that included the matching variables as covariates. Results For ionizing radiation, the ORs were close to unity. For UV and ELF radiation, the highest exposed group of workers had ORs of 1.32 (95% CI = 0.96–1.81) and 1.25 (95% CI = 0.91–1.72), respectively. For UV radiation there was a positive dose–response when exposure was lagged by 5 and 10 years (P for trend 0.04 for both lag periods). Workers in the upper tertile of exposure for RF radiation had an OR of 3.15 (95% CI = 0.63–15.87), but the estimate was based on very small numbers. Conclusions Our results do not provide support for an association between NHL and occupational exposure to ionizing or ELF radiation. For UV radiation, our findings are consistent with a weak positive association. Further investigation focusing on UV and RF radiation and NHL is required.     

5-Aza/TSA表观遗传处理诱导非霍奇金淋巴瘤B细胞表型丢失

目的:探讨5-氮杂-2’-脱氧胞苷/曲古抑菌素A(5-Aza/TSA)介导的DNA去甲基化/组蛋白乙酰化处理对B细胞来源的非霍奇金淋巴瘤B细胞表型的影响。方法:构建含有G418抗性的CD19特异性启动e GFP表达载体,转染霍奇金(阴性对照)和非霍奇金淋巴瘤细胞,并筛选目的序列稳定整合的克隆,比较CD19启动子在2组细胞中的活性。流式细胞术检测5-Aza/TSA处理对2组细胞GFP表达水平的影响。分离Eμ-myc转基因小鼠非霍奇金淋巴瘤原代细胞并鉴定其B细胞表型,通过流式细胞术检测5-Aza/TSA对其B细胞表面抗原CD19等表达水平的影响。结果:5-Aza/TSA表观遗传处理能够降低人非霍奇金淋巴瘤细胞中外源性CD19启动子的转录活性,并沉默小鼠原代非霍奇金淋巴瘤细胞表面B细胞特异性抗原的表达。结论:DNA甲基化和组蛋白去乙酰化对人类及小鼠B细胞来源的非霍奇金淋巴瘤B细胞表型稳定有重要作用。     

Survival variations by country and age for lymphoid and myeloid malignancies in Europe 2000–2007: Results of EUROCARE-5 population-based study

BackgroundSignificant advances in the management of patients with lymphoid and myeloid malignancies entered clinical practice in the early 2000’s. The EUROCARE-5 study database provides an opportunity to assess the impact of these changes at the population level by country in Europe. We provide survival estimates for clinically relevant haematological malignancies (HM), using the International Classification of Diseases for Oncology 3, by country, gender and age in Europe.MethodsWe estimated age-standardised relative survival using the complete cohort approach for 625,000 adult patients diagnosed in 2000–2007 and followed up to 2008. Survival information was provided by 89 participating cancer registries from 29 European countries. Mean survival in Europe was calculated as the population weighted average of country-specific estimates.ResultsOn average in Europe, 5-year relative survival was highest for Hodgkin lymphoma (81%; 40,625 cases), poorest for acute myeloid leukaemia (17%; 57,026 cases), and intermediate for non-Hodgkin lymphoma (59%; 329,204 cases), chronic myeloid leukaemia (53%; 17,713 cases) and plasma cell neoplasms (39%; 94,024 cases). Survival was generally lower in Eastern Europe and highest in Central and Northern Europe. Wider between country differences (>10%) were observed for malignancies that benefited from therapeutic advances, such as chronic myeloid leukaemia, chronic lymphocytic leukaemia, follicular lymphoma, diffuse large B-cell lymphoma and multiple myeloma. Lower differences (<10%) were observed for Hodgkin lymphoma.ConclusionsDelayed or reduced access to innovative and appropriate therapies could plausibly have contributed to the observed geographical disparities between European regions and countries. Population based survival by morphological sub-type is important for measuring outcomes of HM management. To better inform quality of care research, the collection of detailed clinical information at the population level should be prioritised.     

Association of the Asp312Asn and Lys751Gln polymorphisms in the XPD gene with the risk of non-Hodgkin’s lymphoma:evidence from a meta-analysis

Polymorphisms in DNA repair genes may alter DNA repair capacity and, consequently, lead to genetic instability and carcinogenesis. Several studies have investigated the association of the Asp312Asn and...