摘要
目的探讨初诊、初治霍奇金淋巴瘤（HL）患者的临床特征、疗效、预后及其影响因素。方法回顾性分析135例初诊、初治HL患者临床资料，采用SPSSi8．0统计软件分析影响其疗效及预后的不良因素。结果135例患者中男78例，女57例，中位年龄32（7～77）岁。中位随访时间42（12—141）个月。135例HL患者发病高峰年龄段介于20～30岁间，69．6％患者以淋巴结肿大为首发症状，病理以混合细胞型（MC）和结节硬化型（NS）为主，分别占所有病例的59．7％及34．0％；MC亚型中男性较多（66．2％），而NS亚型女性较多（61．4％）。114例随访资料完整的患者中达完全缓解者73例（64．0％），总有效率为77．2％。2、3及5年总体生存率分别为91．2％、88．0％和80．9％，无进展生存率分别为81．6％、80．3％及76．O％。早期预后不良型患者中96．3％接受足疗程化疗，13例（48．1％）联合局部放疗；其3、5年生存率高于预后良好型及进展期患者，但差异无统计学意义。年龄345岁、B组症状分别是影响MC亚型和NS亚型患者疗效的不良因素；年龄／〉45岁、有B症状、肝脏肿大为影响患者预后的独立危险因素（P值均〈0．05）。结论HL多发于年轻患者（〈45岁），初诊多处于疾病早期；以MC亚型为主；B症状是影响疗效及预后的不良因素。对患者进行适宜疗程的标准剂量化疔结合放疗获益最好。
Objective To investigate the clinical characteristics, therapeutic effects, long-term survival and prognostic factors of the newly diagnosed patients with Hodgkin lymphoma （HL）. Methods One hundred and thirty five newly diagnosed HL patients in West China hospital from January 1, 2000 to December 31, 2010 were analyzed retrospectively. Software SPSS18.0 was applied to determine the risk factors for therapeutic results and long term survivals. Results Of 135 patients, 78 cases were male and 57 female, the mediaCn age was 32 （7-77） years old, and the median follow-up of 42 （12-141 ） months. The peak age of HL was 20 to 30 years old and lymph node enlargement was the first presenting symptom in 69.63% of the patients. Among the all pathological types of HL, mixed-cellularity subtype （MC） and nodular sclerosing （NS） were the most common types, accounting for 59.7% and 34.0%, respectively. In MC subtypes, 66.2% of patients were male, while in NS subtypes, 61.4% were female. Among the 114 patients with complete follow-up data, 73 patients （64.0%） obtained complete remission and the total response rate was 77.2%. The 2-, 3- and 5-year overall survival （OS） rates were 91.2%, 88.0% and 80.9%, respectively. The progression free survival rates were 76%, 80.3% and 81.6%%, respectively. Among the patients with early unfavorable prognosis, 96.3% of them accepted full course chemotherapy and 13 （48.1%） were combined with local radiotherapy. The 3- and 5-year survival rates of early unfavorable patients were higher than that of early favorable and advanced patients, but the difference was not statistically significant. Age≥45 years old and B symptom were adverse factors affecting curative effect for MC and NS subtypes, respectively. Furthermore, Age≥45 years, B symptoms and hepatomegaly were independent risk factors affecting the survival. Conclusion HL is more common in young patients （age〈 45 years old） and usually diagnosed at the early stage, with predominance of MC subtypes. B symptoms were adverse prognostic factors of therapeutic effects. The standard-dose chemotherapy and suitable courses of treatment combined with radiotherapy may provide the best benefits for the HL patients.
出处
《中华血液学杂志》
CAS
CSCD
北大核心
2014年第4期304-308,共5页
Chinese Journal of Hematology
关键词
淋巴瘤
霍奇金
临床分析
疗效
预后
生存分析
Lymphoma, Hodgkin
Clinical analysis
Therapeutic effects
Prognosis
Survival analysis
