摘要
目的分析原发性甲状腺淋巴瘤的临床表现、诊断、治疗及预后。方法回顾1995至2005年间我院收治的原发性甲状腺淋巴瘤30例,分析其临床表现、病理分型、临床分期、治疗方案及预后。结果原发性甲状腺淋巴瘤总的2及5年生存率分别为86.7%和73.7%。手术治疗组、手术+放疗组、手术+化疗组、手术+放疗+化疗组5年生存率分别为66.7%、100%、77.8%和71.4%,组间无统计学差异。低度恶性/惰性淋巴瘤组2、5年生存率分别为92.9%和92.9%,高于中高度恶性/侵袭性淋巴瘤组的71.4%和47.6%,二者间差异有非常显著性(P<0.01)。Ⅰ期患者2、5年生存率分别为90.9%和90.9%,高于Ⅱ期的75.0%和58.3%,二者间差异有显著性(P<0.05)。本组的甲状腺淋巴瘤生存率在年龄、性别、血清乳酸脱氢酶(LDH)、血清β2-微球蛋白(β2-MG)、手术方式、气管切开组间差异无显著性。结论甲状腺淋巴瘤的预后与病理分型、临床分期及治疗方案密切相关。治疗以手术+放疗+化疗综合治疗为主,但应根据患者的具体情况(年龄、病理类型、临床分期、肿瘤大小、全身情况等)选择治疗方式。
Objective To analyze the clinical presentation, pathological type, diagnosis, treatment and prognosis of primary thyroid lymphoma（PTL）. Methods Thirty eases of primary thyroid lymphoma ad- mitted to our hospital from 1995 to 2005 were reviewed. Results The 2-year and 5-year survival rates of PTL were 86. 7% and 73. 7% respectively. Treatments included surgery alone, surgery plus radiotherapy, surgery plus chemotherapy and surgery plus radiotherapy and chemotherapy. There were no significant differences in 5-year survival rates between four groups. Survival rate of I E was higher than that of IIE （ P 〈 0. 05 ）. Survival rate of patients with low-grade/indolent thyroid lymphoma was higher than that of patients with high-grade/aggressive lymphoma （P 〈 0. 01 ）. There was no significant difference between each pair as follows ： age （ 〉 60/〈 60 ） , sex（ male/female ）, serum LDH （ normal/high ） , serum [β2-MG （normal/high） , surgery （radical operation/non-radical operation） , tracheotomy/no tracheotomy. Conclusion The prognostic factors of PTL are mainly associated with pathology type ,clinical stage. The treatment is mainly combined modality including surgery,radiotherapy and chemotherapy and should be based on patients＇ conditions （age, pathology type, clinical stage, tumor size, performance status）. The important role of surgical management for thyroid lymphoma is irreplaceable.
出处
《中国肿瘤临床与康复》
2008年第2期125-128,共4页
Chinese Journal of Clinical Oncology and Rehabilitation
关键词
甲状腺肿瘤
淋巴瘤
Thyroid neoplasms
Lymphoma
