天津医药

天津医药 ›› 2016, Vol. 44 ›› Issue (9): 1128-1131.doi: 10.11958/20160076

• 临床研究 • 上一篇    下一篇

27 例套细胞淋巴瘤的临床特征及预后分析

张曼， 赵阔， 杨芳， 张会来△， 邱立华， 周世勇， 钱正子， 李兰芳   

  1. 天津医科大学肿瘤医院， 国家肿瘤临床医学研究中心， 天津市“肿瘤防治”重点实验室， 综合内一科（邮编 300060）
  • 收稿日期:2016-02-29 修回日期:2016-04-07 出版日期:2016-09-15 发布日期:2016-09-28
  • 通讯作者: 张会来 E-mail:xiaobuding126@126.com
  • 作者简介:张曼（1987）， 女， 住院医师， 硕士研究生， 主要从事淋巴瘤内科治疗研究

Analysis of clinical features and prognosis of 27 patients with mantle cell lymphoma

ZHANG Man, ZHAO Kuo, YANG Fang, ZHANG Huilai△, QIU Lihua, ZHOU Shiyong, QIAN Zhengzi, LI Lanfang   

  1. Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, China
  • Received:2016-02-29 Revised:2016-04-07 Published:2016-09-15 Online:2016-09-28
  • Contact: , ZHANG Huilai E-mail:xiaobuding126@126.com

PDF (PC)

3827

摘要： 目的 探讨套细胞淋巴瘤（MCL）的临床特征、化疗方案的疗效及预后情况。 方法 回顾性分析 27 例 MCL 患者资料， 分析其临床特征及治疗方案， 采用 Cox 回归分析 MCL 预后的影响因素。 结果 27 例患者中位发病年龄为 68 岁， 男女比例为 4.4∶ 1， Ann Arbor 分期Ⅲ～ Ⅳ者 25 例（92.6%）， 肝脾肿大者 8 例（29.6%）， 淋巴结外受累部位＞ 2 者 7 例（25.9%）、 ECOG 评分 2～ 4 分者 4 例（14.8%）， MIPI 评分 0～ 3 分者 8 例（29.6%）、 4～ 5 分者 14 例（51.9%）、6～ 11 分者 5 例（18.5%）， Ki-67≤30%者 9 例（33.3%）， ＞ 30%者 18 例（67.7%）， 有 B 症状者 10 例（37.0%），乳酸脱氢酶（LDH）值升高者 17 例（63.0%）， β2-微球蛋白值升高者 8 例（29.6%）， 骨髓浸润者 7 例（25.9%）。 R-CHOP 方案组总有效率（ORR）为 81.8%， CHOP 方案组 ORR 为 68.8%。 多因素分析示年龄、LDH、Ki-67 为影响 MCL 预后的独立因素（P＜ 0.05）。 结论 MCL 以晚期多见， 年龄＞ 60 岁、LDH 值升高、Ki-67＞ 30%的患者预后不佳。

关键词: 淋巴瘤, 膜细胞, L-乳酸脱氢酶, Ki-67 抗原, 淋巴瘤, 预后, 套细胞淋巴瘤, MIPI 评分

Abstract: Objective To study the clinical features, effects of therapeutic regimen and prognosis of patents with mantle cell lymphoma (MCL). Methods Clinical data of 27 MCL patients admitted in Tianjin Medical University Cancer Institute & Hospital from January 2008 to December 2014 were retrospectively analyzed. Cox regression analysis was used to analyze influencing factors of prognosis of MCL. Results The median age was 68 years old for 27 patients, and the male-tofemale ratio was 4.4∶ 1. Ann Arbor staging showed that 25 cases were stage Ⅲ-Ⅳ(92.6%), 8 cases were heptosplenomegaly (29.6%), 7 cases showed extranodal involvement (25.9%). ECOG scoring showed that 4 cases with scores of 2-4 (14.8%), 8 cases were 0-3 (29.6%), 14 cases were 4-5 (51.9%) and 5 cases were 6-11 (18.5%). The Ki-67 index ≤30% was found in 9 cases (33.3%), and＞ 30% was found in 18 cases (67.7%). Patients with B symptom was found in 10 (37.0%). The elevated lactate dehydrogenase (LDH) was found in 17 cases (63.0%). The increased Beta 2- microglobulin was found in 8 cases (29.6%). Seven patients were found with bone marrow involvement. The total effective rate (ORR) was 81.8% in group with R-CHOP method, and the ORR was 68.8% in group with CHOP method. Multivariate analysis showed that age, LDH and Ki- 67 were independent factors influencing the prognosis of MCL (P＜ 0.05). Conclusion Most patients with MCL are found in advanced stage. Patients with age＞ 60 years, elevated LDH and Ki-67 index＞ 30% are with poor prognosis.

Key words: lymphoma, mantle- cell, L- lactate dehydrogenase, Ki- 67 antigen, lymphoma, prognosis, mantle cell lymphoma, MIPI score