滤泡型淋巴瘤患者临床特征及预后因素分析

目的:分析滤泡型淋巴瘤（follicular lymphoma,FL）患者的临床特征及预后因素。方法:对2006年至2016年115例经我院病理科确诊为FL患者进行回顾性病理及临床特征分析，其中62例住院诊治的患者中，30例接受含有利妥昔单抗方案的治疗，22例患者进行普通化疗，10例患者未行任何治疗，并随访观察。结果:62例患者中，利妥昔单抗联合化疗组和单用化疗组，2年OS率均为100%，5年OS率分别为90%和70%，OS间无显著性差异（P=0.332 5）。2年PFS率分别为94%和84%，5年PFS率分别为84%和49%，PFS间有显著性差异（P=0.025 3）。FLIPI-2预后分析，中危组中利妥昔单抗联合化疗与单用化疗组间2年PFS分别为100%、80%，有显著性差异（P=0.021 9），低危组中利妥昔单抗联合化疗与单用化疗组间2年PFS分别为100%、95%，高危组中利妥昔单抗联合化疗与单用化疗组间2年PFS分别为92%、76%，低危组和高危组中利妥昔单抗联合化疗与单用化疗组相比PFS均无显著性差异。CD10表达阳性组的总反应率（37.14%）明显高于阴性组（22.86%）。结论:FL好发于60岁以下男性，结外病变少见，预后分层多为低危组。规律利妥昔单抗联合化疗可以进一步提高缓解率，延长生存期。

Clinical characteristics and prognostic factors of patients with follicular lymphoma

Objective:To study the　clinical characteristics and prognostic factors of patients with follicular lymphoma(FL).Methods:A retrospective analysis of pathological and clinical features of 115 cases of FL diagnosed by pathology department from 2006 to 2016，in the 62 hospitalized patients，30 patients received rituximab regimen，22 patients received general chemotherapy，10 patients did not receive any treatment and were followed up.Results:There was no significant difference in OS between rituximab combined with chemotherapy and only chemotherapy groups（P=0.332 5），2-year OS rate was 100%，5-year OS rate were 90% and 70%.There was a significant difference between PFS（P=0.025 3），2-year PFS rate were 94% and 84%，5-year PFS rate were 84% and 49%.In the prognosis analysis of FLIPI-2，in the middle risk group，the 2-year PFS of the rituximab combined with chemotherapy and only chemotherapy groups was 100% and 80%，there was significant difference between the two groups（P=0.021 9）.In the low risk group，the 2-year PFS of the rituximab combined with chemotherapy and only chemotherapy groups was 100% and 100%.In the high risk group，the 2-year PFS of the rituximab combined with chemotherapy and only chemotherapy groups was 92% and 76%.There was no significant difference in PFS between the low risk group and the high risk group with the rituximab combined with chemotherapy and only chemotherapy groups.The total reaction rate of CD10 positive group (37.14%) was significantly higher than that of negative group (22.86%).Conclusion:FL is more common in men under 60 years of age.Extranodal lesions are rare.Prognostic stratification is mostly low risk group.Rituximab combined with chemotherapy can improve the remission rate and prolong the survival time.