原发性扁桃体NHL临床特点和预后分析

目的:扁桃体是淋巴结外恶性淋巴瘤的好发部位,本研究对扁桃体恶性淋巴瘤的临床特点和预后因素进行分析,探讨临床指标与预后的关系。方法:对我院1990年1月至2000年12月收治的26例原发于扁桃体的恶性淋巴瘤患者的临床特点,预后因素、治疗进行总结,并结合文献进行分析。结果:本组扁桃体恶性淋巴瘤患者以中老年居多,病理均为非霍奇金淋巴瘤(non-hodgkin'slymphoma,NHL)。中高度恶性居多。全组5年总生存率、癌症相关生存率、无瘤生存率分别为68%、70.8%、61%。死亡15例,12例死于肿瘤本身,3例死于并发症。Cox多因素分析显示,年龄、国际预后指数(internationalprognosticIndex,IPI)、血清乳酸脱氢酶(serumlactatedehydrogenase,LDH)、一般状况和分期是影响预后的独立因素。结论:原发于扁桃体的非霍奇金淋巴瘤,年龄、IPI、LDH、一般状况和分期是预后的重要指标。早期发现,早期治疗是提高生存率的重要途径。

Clinical analysis of primary non-Hodgkin's lymphoma of tonsil

Objective: The most common site of extranodular type non -Hodgkin's lymphoma(NHL) is the palatine tonsil.The purpose of this study was to investigate the clinical features and prognostic factors of NHL of the tonsil. Methods:Twenty-six patients with primary NHL of tonsil were treated between Jan.1990 to Dec.2000.Clinical data(age,pathologic features,stage,etc.),and treatment results and prognostic factors were investigated. Results:More patients were over 50 years old,all patients were pathologically proven to be NHL . The 5-year overall survival rate,cancer specific survival rate and disease-free survival rate were 68%,70.8%,61%. 15 patients died,12 died of tumor,3 died of complication. Multivariate analysis showed that age, international prognostic index, serum lactate dehydrogenase, general status and clinical stage were independent prognostic factors. Conclusion:Age, international prognostic index, general status and clinical stage are important prognostic factors for NHL of the tonsil. Diagnosis early ,treatment early is the important way to improve the prognosis.