摘要
目的：探讨间变性非霍奇金淋巴瘤(ALCL)的诊断、临床病理特点、治疗方法及预后。方法：复习1994年6月至1998年12月我院原诊断为大细胞淋巴瘤、霍奇金病等病例的HE染色切片及部分免疫组化切片，根据1992版的最新Kiel分类有关ALCL的诊断标准，筛选组织形态符合ALCL，有详细的临床、治疗及随访资料，经单克隆抗体BerH2标记阳性可确诊为ALCL的病例20例，进一步检测LCA、L26、UCHL1，对部分BerH2、L26阳性病例进行CD15的检测。本组患者均采用以CHOP为主的联合化疗方案，无效或4个疗程不能取得完全缓解用解救方案(IMVP16、DHAP)或局部放疗。结果：本组年轻男性发病多见，主要体征为全身浅表淋巴结肿大(80％)，部分可累及纵隔(30％)、腹腔(25％)、盆腔淋巴结(20％)，结外组织也可受累，其中最常见是皮肤溃疡(30％)。确诊时较多患者AnnArbor分期为Ⅲ期(35％)和Ⅳ期(35％)，且有B症状(55％)和LDH水平升高(70％)。全组BerH2阳性，免疫表型以T细胞为主(60％)，部分为B细胞(35％)或非B非T(5％)。近期疗效：有效率(CR＋PR)17例(85％)，其中完全缓解(CR)12例(60％)。1年、2年、3年生存率均为54.9％。首次化疗是否CR、B症状、有巨大病变均为影响生存的因素。结论：ALCL是一种具有特殊免疫表型和临床特点的非霍奇金淋巴?
Objective： To explore the clinicopathologic features of anaplastic large cell lymphoma(ALCL) and to discuss the treatment and prognostic factors of ALCL. Methods： According to undated Kiel classification, 20 patients of ALCL with CD30 positive were selected for investigation. A panel of monoclonal antibodies were applied： LCA,L26,UCHL1,CD15. All clinical data were reviewed and all patients were followed up.Twenty patients were treated with combination chemotherapy including CHOP regimen. If the patient had no effect or still partial response after 4 cycles, salvage regimen(IMVP16 or DHAP) or radiotherapy would be given. Results： The median age was 28 years (range, 11 to 52 years); the male： female radio was 3∶ 1. Peripheral adenopathy was present in 16(80％ ) patients. The most common extranodal site was skin with 6(30％ ) involved. B symptoms and LDH abnormal were commonly observed. Fourteen patients had stage Ⅲ or Ⅳ disease at diagnosis. Immunophenotype were T cell in 12 patients and B cell in 7 patients. The total response rate was 85％ ,with CR rate of 60％ . 1 year, 2 year and 3 year survival rate were same 54.9％ . The prognosis of ALCL was related with B symptom,bulky disease and achievement of CR following chemotherapy. Conclusion： ALCL is a distinct subtype of non Hodgkin s disease. Our preliminary data suggested that most ALCL will respond to combination chemotherapy including CHOP resulting in good outcome, However, more cases will be needed for confirmation.
出处
《癌症》
SCIE
CAS
CSCD
北大核心
2000年第9期914-917,共4页
Chinese Journal of Cancer
