西南地区鼻和鼻型NK/T细胞淋巴瘤的临床病理特征及预后分析

目的分析西南地区鼻和鼻型NK/T细胞淋巴瘤的临床病理特征及影响预后的因素.方法分析120例鼻和鼻型NK/T细胞淋巴瘤的病理形态及免疫表型、临床特点、治疗和生存情况.结果120例患者总的5年生存率为54.1%.大型瘤细胞生存率较中小型瘤细胞低(P＜0.01),病变中有坏死及血管浸润者生存率明显低于对照组(P＜0.05),而瘤细胞分布及患病年龄与预后关系不大,临床Ⅰ～Ⅱ期与Ⅲ～Ⅳ期两组病例生存率差异有显著性(P＜0.01),累及多个部位、伴有穿孔及全身症状者生存率低于对照组(P＜0.05).综合治疗疗效优于单一治疗及未治疗组(P＜0.01),单一治疗近期疗效好,而远期疗效与未治疗组差异无显著性(P＞0.05).Cox Regression分析结果亦表明瘤细胞大小、分期及治疗方法与预后密切相关.结论瘤细胞大小、坏死、血管浸润、穿孔、B症状、分期、病变范围和治疗方法与鼻和鼻型NK/T细胞淋巴瘤的预后相关,其中瘤细胞大小、分期和治疗方法是其主要的预后因素.

Clinicopathologic features and prognostic factors of nasal and nasal-type NK/T lymphoma in south-west part of China

Objective To investigate the clinicopathologic features, prognostic factors and the prognosis of nasal and nasal-type NK/T-cell lymphoma in south-west of China. Methods The clinicopathologic features, immunophenotypes and treatment of 120 patients with nasal and nasal-type NK/T-cell lymphoma were analyzed. Results The overall 5-year survival rate for all cases was 54.1%, and correlated well with the size of tumor cells, necrosis, angiocentricity, the stage, sites of involvement, and perforation(P<0.05); but not with the distribution of tumor cells and the age of patients at the presentation (P>0.05). The overall survival rate of patients with combined therapy was higher than that of patients with radiotherapy or chemotherapy alone or untreated ones (P<0.01). Even though the patients with radiotherapy or chemotherapy alone had a relatively favorable short-term results, the long-term curative effect for those patients was not better than that of untreated patients (P>0.05). Furthermore, the size of tumor cells, stage, and treatment were well correlated with the prognosis of these patients by Cox Regression. Conclusion The prognosis of nasal and nasal-type NK/T-cell lymphoma was significantly correlated with the size of tumor cells, necrosis, angiocentricity, stage, sites of involvement, perforation and treatment, especially with the size of tumor cells, stage, and treatment.