摘要
目的观察生殖系统原发性非霍奇金淋巴瘤的临床病理表现及免疫表型,并分析其与预后的关系。方法回顾性分析43例女性生殖系统原发性非霍奇金淋巴瘤的临床病理资料,按WHO(2001年)关于淋巴造血组织肿瘤的分类标准进行病理类型的分类,采用免疫组化染色、原位杂交及 PCR 技术分别检测其免疫表型、EB 病毒感染及免疫球蛋白重链基因重排。采用 Cox 回归模型对生殖系统原发性非霍奇金淋巴瘤的预后进行多因素分析。结果 (1)原发灶部位:卵巢24例,子宫内膜3例,宫颈10例,阴道2例,外阴4例;(2)临床分期:Ⅰ期12例,Ⅱ期9例,Ⅲ期22例;(3)病理类型:经病理活检、免疫组化、原位杂交及 PCR 技术检测结果显示,弥漫性大 B 细胞淋巴瘤37例(86%),伯基特淋巴瘤和非特指外周 T 细胞淋巴瘤各3例;(4)预后分析:乳酸脱氢酶水平增高、临床Ⅲ期、弥漫性大 B 细胞淋巴瘤及单纯手术治疗患者的生存率明显低于乳酸脱氢酶水平正常、临床Ⅰ和Ⅱ期、伯基特淋巴瘤和非特指外周 T 细胞淋巴瘤、手术+化疗和手术+放化疗者(P<0.05)。Cox回归模型多因素分析显示,乳酸脱氢酶水平、临床分期、病理类型及治疗方案均为影响原发性非霍奇金淋巴瘤患者预后的独立因素(P<0.05)。结论病理活检、免疫组化、原位杂交及 PCR 技术检测对生殖系统原发性非霍奇金淋巴瘤的诊断和鉴别诊断具有重要作用。乳酸脱氢酶水平、临床分期、病理类型及治疗方案均为女性生殖系统原发性非霍奇金淋巴瘤的独立预后因素。
Objective To investigate the clinicopathology and immunophenotype of primary non-Hodgkin lymphoma （NHL） of the female genital system, and to analyze the prognosis of such tumors. Methods Clinicopathologic features of 43 cases of primary NHL of the female genital system were studied retrospectively, with the histological classification based on the Classification of Haematopeietic and Lymphoid Tumors （ WHO, 2001 ）. Immunochemistry technique, in-situ-hybridization and polymerase chain reaction methods were used to detect the immunophenotype, epstein barrvirus （EB） virus infection status and immunoglobulin heavy chain gene rearrangement, respectively. Results （ 1 ） Primary lesions： there were 24 cases of lymphoma originating in the ovary, 3 cases in the endometrium, 10 cases in the cervix, 2 cases in the vagina and 4 cases in the vulva. （2） Staging： 12 cases （28%） were in stage Ⅰ , 9 cases （21%） in stage Ⅱ ,and 22 cases （51%） in stage Ⅲ. （3）Histological classification： 37 cases（86% ） were diffuse large B cell lymphoma（ DLBCL）, 3 cases were Burkitt lymphoma and the remaining 3 cases were unspecified peripheral T-cell lymphoma according to biopsy, immunophenotype analysis, in-situ-hybridization technique and IgH gene rearrangement detection. （4） Prognosis analysis：increase in the level of lactic acid dehydrogenase, stage Ⅲ, DLBCL and single operation suggest poor prognosis. Conclusions Establishment of the diagnosis of primary NHL of the female genital system is based on biopsy, immunophenotype analysis, in-situ-hybridization technique and IgH gene rearrangement detection, which play important roles in diagnosis and differential diagnosis of the tumor. Combined therapy is the first choice of therapeutic regimens.
出处
《中华妇产科杂志》
CAS
CSCD
北大核心
2007年第4期222-226,共5页
Chinese Journal of Obstetrics and Gynecology
