【摘要】：目的探討乳腺原發(fā)性淋巴瘤(PBL)患者臨床病理特征及預(yù)后影響因素。方法回顧性分析43例PBL患者的臨床資料,總結(jié)PBL患者的臨床病理特征及預(yù)后影響因素。結(jié)果全組43例患者均為女性,中位年齡50歲,首發(fā)癥狀多為無痛性腫物,腫物多位于乳腺外上象限(58.1%)。術(shù)前乳腺B超及鉬靶難與良性腫瘤區(qū)分,乳腺粗針穿刺及快速冰凍病理診斷率亦不高。手術(shù)后病理診斷彌漫大B細(xì)胞淋巴瘤(DLBCL)30例,淋巴母細(xì)胞型淋巴瘤2例,黏膜相關(guān)淋巴組織型結(jié)節(jié)外邊緣區(qū)B細(xì)胞淋巴瘤(MALT淋巴瘤)、濾泡性淋巴瘤、淋巴漿細(xì)胞淋巴瘤、小淋巴細(xì)胞淋巴瘤各1例。43例患者中38例行手術(shù)加化療,9例行術(shù)后放療,化療方案以CHOP為主。中位隨訪時間33個月,5年總生存率和無病生存率分別為42%和20%。年齡、臨床分期、國際預(yù)后指數(shù)(IPI)為總生存的獨立預(yù)后因素(P均0.01);而臨床分期(P=0.03)、IPI(P=0.01)、放療(P=0.02)為無病生存的獨立預(yù)后因素。骨髓為最常見轉(zhuǎn)移部位,其次為同側(cè)及對側(cè)乳腺。結(jié)論 PBL以DLBCL多見,預(yù)后差,復(fù)發(fā)轉(zhuǎn)移早,影像學(xué)檢查缺乏特異性,手術(shù)僅能明確診斷;應(yīng)采取以化療、放療為主的綜合方案治療。
[Abstract]:Objective to investigate the clinicopathological features and prognostic factors of primary breast lymphoma (PBL). Methods the clinical data of 43 patients with PBL were analyzed retrospectively. The clinicopathological features and prognostic factors of PBL were summarized. Results all 43 patients were female with median age of 50 years. Most of the initial symptoms were painless masses, most of which were located in the superior quadrant of the mammary gland (58.1%). It is difficult to distinguish benign tumors from benign breast by B-ultrasound and mammography before operation, and the diagnostic rate of coarse needle puncture and rapid freezing pathology is not high. 30 cases of diffuse large B cell lymphoma (DLBCL), 2 cases of lymphoblastoid lymphoma, 2 cases of MALT lymphoma, follicular lymphoma, lymphoplasmacyte lymphoma were diagnosed by pathology after operation. In 43 cases, 38 cases were treated with operation plus chemotherapy, 9 cases with postoperative radiotherapy. CHOP was the main chemotherapy regimen. The median follow-up time was 33 months. The 5-year overall survival rate and disease-free survival rate were 42% and 20%, respectively. Age, clinical stage and international prognostic index (IPI) were independent prognostic factors of total survival (P0. 01), while clinical stage (P0. 03), IPI (P0. 01) and radiotherapy (P0. 02) were independent prognostic factors of disease-free survival. Bone marrow was the most common metastatic site, followed by ipsilateral and contralateral mammary glands. Conclusion DLBCL is more common in PBL with poor prognosis, early recurrence and metastasis, lack of specificity in imaging examination, and only definite diagnosis after operation, and should be treated with chemotherapy and radiotherapy.
【作者單位】： 天津醫(yī)科大學(xué)腫瘤醫(yī)院國家腫瘤臨床醫(yī)學(xué)研究中心天津市腫瘤防治重點實驗室乳腺癌防治教育部重點實驗室;
【分類號】：R737.9

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