摘要
目的 探讨原发睾丸淋巴瘤（PTL）的临床特点及其与预后的相关性. 方法回顾性分析1977年6月至2009年5月收治的33例PTL患者的临床资料,以Kaplan-Meier法绘制生存曲线,Log-rank检验进行单因素分析,采用COX回归模型多因素分析评估独立的预后因素. 结果 33例患者中位发病年龄为62（33～81）岁,24例就诊时处于早期,首发症状主要表现为睾丸无痛性肿大,最常见的病理类型是B细胞淋巴瘤,占76%（25/33）,其中弥漫大B细胞淋巴瘤占48%（16/33）.经术后化疗和（或）放疗,23例完全缓解,7例部分缓解.中位随访时间23（4～231）个月.5、10年总生存率分别为39.1%和19.5%.化疗≥4个周期及B细胞淋巴瘤加利妥昔单抗患者疗效好.多因素分析显示：Ann Arbor分期、B症状、年龄和结外受侵数是PTL的独立预后因素. 结论 PTL应采取综合治疗,术后给予蒽环类药物为主的全身化疗,B细胞淋巴瘤首选利妥昔单抗联合化疗,预防性鞘内注射和对侧睾丸预防性放疗有助于减少复发.Ann Arbor分期、B症状、年龄和结外受侵数为PTL预后的独立影响因素.
Objective To discuss the clinical features and prognostic factors of primary testicular lymphoma （PTL）. Methods A retrospective review was performed based on the clinical records of 33 PTL cases treated at Tianjin Medical University Cancer Hospital from June 1977 to May 2009.Drawing survival curves by Kaplan-Meier method, using Log-rank test to the univariate analysis, and multivariate analysis by COX regression model to evaluate independent prognostic factors. Results The median age of patients was 62 years at presentation（range 33-81 years）. Painless testicular swelling was the initial symptom. The majority of histological subtype was B cell lymphoma, 48% of which was diffuse large B-cell non-Hodgkin＇s lymphoma. By postoperative chemotherapy and/or radiotherapy, 23 patients achieved complete remission and 7 achieved partial remission, with a median follow-up of 23 months （4-231 months）. The 5 years and 10 years of overall survival was 39.1% and 19.5%. The effect of patients who received chemotherapy≥4 cycles and B cell lymphoma patients combination with Rituximab were better. In multivariate analysis, Ann Arbor stage, B symptoms, age of patient and number of extranode site were independent prognostic factors of survival. Conclusions Primary non-Hodgkin lymphoma should be treated with multi-modality strategies. Treatment with doxorubicin-based chemotherapy after orchiectomy should be recommended. Ann Arbor stage, B symptoms, age of patient and number of extranode site were independent prognostic factors of survival in PTL.
出处
《中华泌尿外科杂志》
CAS
CSCD
北大核心
2010年第11期777-781,共5页
Chinese Journal of Urology
关键词
原发性睾丸淋巴瘤
B细胞淋巴瘤
临床特点
预后
Primary testicular lymphoma
B cell lymphoma
Clinical character
Prognosis
