摘要
目的：回顾性分析原发性乳腺淋巴瘤（PBL）的临床病理特征、治疗经过及预后因素，探讨更好的治疗模式。方法：收集1992年9月，2006年5月间本院收治的37例原发性乳腺淋巴瘤（PBL）的临床发病特点、治疗经过及疗效、预后随访结果。结果：37例PBL患者，均为女性，中位年龄45岁（29～82岁）。根据Ann Arbor分期标准，ⅠE期16例，ⅡE期12例，ⅢE和ⅣE期9例，病理类型均为B细胞性非霍奇金淋巴瘤，以弥漫性大B细胞淋巴瘤为主（26例例／37例）。治疗情况：单纯根治术组2例，手术＋化疗组21例（其中乳房根治或改良根治手术12例，象限切除手术9例），乳腺局部放疗＋化疗组8例，单纯化疗组6例，化疗一般采用CHOP方案，4～6个周期。随访时间1个月～120个月，中位随访时间36个月。全部患者中位生存时间为53个月，3年生存率为80％，5年生存率为38％。手术＋化疗组和放疗＋化疗组，5年生存率无明显差异（38．1％和37．5％，P=0．20）。原发肿瘤大小及临床分期是预后主要相关因素（P=0．04和P=0．01）。结论：PBL多为女性患者，好发生于单侧乳腺，病理以弥漫性大B细胞型最常见。治疗应以局部放疗联合全身化疗为主，须定期随访观察。
Objective： To explore the clinicopathologic features, optimal treatment and prognostic factors of primary breast lymphoma （PBL）. Methods： The clinical records of 37 PBL patients treated in our hospital from 1992 to 2006 were retrospectively reviewed. Results： All of the 37 PBL patients were female with an average age of 45 years. According to the Ann Arbor stage standard, 16 cases were of stage Ⅰ E, 12 cases were of stage Ⅱ E, and 9 cases were of stage Ⅲ E/Ⅳ E. According to the WHO 2001 lymphoma classification system, all of the cases were B-cell lymphoma （including 26 cases of diffuse large B-cell lymphoma）. Of all the patients, 2 underwent surgery alone, 21 cases received surgery combined with chemotherapy （14 cases had mastectomy and 9 cases underwent local excision）, 8 cases received radiotherapy combined with chemotherapy, and the other 6 cases received chemotherapy alone. The chemotherapy regimen used was CHOP for an average of 4-6 cycles. The median follow-up was 36 months （ranging from 1-120 months）. The median survival time was 53 months. The 3- and 5-year overall survival （OS） rates were 80% and 38%, respectively. No statistical significance was found between patients treated with surgery and those treated with radiotherapy （38.1% and 37.5%, P〉0.05）. A statistical analysis showed that the tumor size and clinical stage at diagnosis were significant prognostic factors. Conclusion： PBL mostly occurs in women and is almost always found unilaterally. The main pathological subtype of PBL is diffuse large B-cell lymphoma. Compared with other treatments, radiotherapy combined with chemotherapy is currently the best treatment. Tumor size and clinical stage at diagnosis are the key factors in predicting survival time.
出处
《中国肿瘤临床》
CAS
CSCD
北大核心
2008年第21期1206-1209,共4页
Chinese Journal of Clinical Oncology
关键词
乳腺肿瘤
淋巴瘤
预后
Breast neoplasm
Lymphoma
Prognosis
