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儿童非霍奇金淋巴瘤的临床特点及预后 被引量:2

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摘要 目的探讨儿童非霍奇金淋巴瘤(NHL)临床表现及影响预后的因素。方法收集2010年3月至2015年12月医院确诊的78例NHL患儿的资料,采用Kaplan-Meier方法计算5年无事件生存率(EFS),用Cox比例风险模型分析年龄、性别、肿瘤大小、免疫分型、B症状、乳酸脱氢酶(LDH)、临床分期等因素对5年EFS的影响。结果 78例NHL的中位发病年龄是7.4岁(1.5~14岁),男女比例2.90:1。其中T细胞型11例,B细胞性67例,病理类型以Burkitt淋巴瘤最常见。根据St.Jude淋巴瘤分期,Ⅰ期2例,Ⅱ期23例,Ⅲ期35例,Ⅳ期18例。11例淋巴母细胞淋巴瘤主要以外周淋巴结增大(80.7%)为首发表现,27例Burkitt淋巴瘤患儿主要以腹腔和口腔牙龈受累。73例进行治疗,化疗2个疗程后,66例完全缓解,4例部分缓解,在治疗1个疗程后,只有2例复发,占比2.7%,化疗过程中只有1例有中枢神经系统浸润的情况。随访42个月后,患儿的5年EFS为(67.0±5.5)%。患儿预后与肿块大小、年龄以及性别等均不具有显著性(P>0.05),患儿预后与LDH水平、B症状以及临床分期具有显著相关性(P<0.05)。从多因素分析结果来看,临床分期与LDH水平都会对患儿的预后造成影响。结论儿童NHL临床表现多样化,初诊时LDH水平、临床分期是影响预后的重要因素。
作者 张本山
机构地区 湖南省儿童医院
出处 《医疗装备》 2017年第1期153-155,共3页 Medical Equipment
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