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30例MALT淋巴瘤的临床特征及生存预后分析
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摘要: 目的 探讨黏膜相关淋巴组织淋巴瘤(MALT淋巴瘤)的临床特征、治疗方案、疗效及预后因素。 方法 回顾分析2001年1月至2010年12月在四川大学华西医院确诊并住院治疗的30例MALT淋巴瘤患者的临床资料,比较不同治疗方案的疗效,进行预后相关因素分析。 结果 30例患者发病年龄介于17~81岁,中位年龄57岁,发病高峰年龄段为50~65岁,男女比例1.5:1。其中Ann Arbor分期Ⅰ~Ⅱ期者占70.0%(21/30)、有B症状者23.3%(7/30)、淋巴结肿大者20.0%(6/30);IPI评分<2分者93.3%(28/30)、Ki-67值<20%者72.7%(16/22)。受累器官包括:骨髓、脾脏、韦氏环、腮腺、甲状腺、肺部、胃部、肠道、眼部、鼻咽部和肺。化疗组、手术联合化疗组和手术治疗组的疗效差异均无统计学意义(有效率分别为81.8%、87.5%和77.8%,P>0.05),分期Ⅲ~Ⅳ期、IPI评分 ≥ 2分、骨髓受累、浅表淋巴结肿大等因素能降低患者的疗效(P<0.05)。3年及5年OS分别为96.7%和90.6%、PFS分别为86.5%和79.9%,单因素分析显示:Ann Arbor分期Ⅲ~Ⅳ期、IPI评分 ≥ 2分、浅表淋巴结受累、骨髓受累及羟丁酸脱氢酶(HBDH)升高、CD5阳性是患者生存预后的不良因素(P<0.05)。经Cox回归模型多因素分析未发现对生存及预后有明显影响的因素。 结论 MALT淋巴瘤多为中老年起病,男性多于女性,常伴器官受累,手术联合化疗能获得较高的有效率;该病总体生存及预后好。
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