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 Clinical Analysis of 30 Patients with Primary Testicular Non-Hodgkin lymphoma

Objective:Testicular lymphoma is a rare occurrence in the category of testicular malignancies.Conversely,primary lymphoma of the testis is rare as a subset of the lymphoma category.The purpose of this study is to analyze the clinicopathologic features and treatment modalities for patients with primary testicular lymphoma,and to review literature that includes the latest reports.Methods:From 1990 to 2005,30 patients were diagnosed with primary testicular lymphoma in our center.Data from the patients were retrospectively analyzed.Results:Median age of the patients was 57.5 years(3-79) ,among which unilateral primary testicular tumor occurred in 25 cases and bilateral occurred in 5 cases.Patients diagnosed with disease of Stage IE or IIE comprised 86.7% of the cohort.Diffuse large B-cell lymphoma and peripheral T-cell lymphoma(non-specified) were found in 23 patients(76.7%) and 4 patients(13.3%) ,respectively.All of the patients underwent orchiectomy.Post-orchiectomy follow-up treatment included CHOP-like chemotherapy in 23 cases and radiotherapy following chemotherapy in 8 cases.Of the 8 patients who were given radiotherapy,5 received scrotum and contralateral testis irradiation.Twenty-one patients achieved CR/Cru and 3 achieved PR.With a median follow-up of 27.9 months,the 5-year OS and progression-free survival(PFS) were 42.3% and 30.3%,respectively.Univariate analysis showed that pathological subtype and IPI score had an effect on prognosis.Conclusion:Primary non-Hodgkin lymphoma should be treated with multi-modality strategies.Treatment with doxorubicin-based chemotherapy after orchiectomy is recommended.CNS prophylaxis and contralateral testis irradiation can decrease the probability for recurrence in the two sites.