摘要
目的 :探讨本院收治的 4 0例朗格罕细胞组织细胞增生症 (LCH)的临床分型 ,分级及治疗情况。方法 :所有的病例均根据临床表现 ,皮疹印片或包块穿刺、病理切片找到典型的泡沫细胞确诊 ,然后进行临床分型 ,依据Cavin和Osband方法分级 ,选择VP和VCP加 6mp +MTX联合化疗定期随访。结果 :临床分型LS 18例 (4 5 % ) ,HSC 12例(30 % ) ,ECB 5例 (12 .5 % ) ,中间型 4例 (10 % ) ,单一器官型 1例 (2 .5 % )。分级I级 12例 (30 % ) ,II级 14例 (35 % )。Ⅲ级 8例 (2 0 % ) ,Ⅳ级 6例 (15 % )。治疗情况 :4 0例中 35例进行了联合化疗 ,总有效率 5 4 .3% (19 35 )。结论 :LCH是一种反应性非肿瘤性增殖性疾病 ,儿童多见 ,临床表现多样性 ,易误诊 ,对可疑病例 ,进行皮疹印片 ,包块穿刺 ,找典型的组织细胞可以确诊。此方法简单 。
Objective: To explore clinical classification, grade, and treatment of 40 patients with Langarhans cell histiocytosis(LCH) treated in our hospital.Methods:All patients were diagnosed on clinical presentation,impressed skin rash slide,mass aspirate,biopsy, and finding langarhans cell.All patients were classified and graded by cavin and Qsband,followed by chemotherapying with vp or vcp add GMP + MTX.The patients were followed up.Results:Clinical classification: 18 cases (45%) belonged to LS;12 cases (3%0) to HSC,and 5 cases (12.5%) to ECB;4 cases (10%) to middle type;1 case(2.5%) to single organ.For grade:12 cases (30%) belonged to grade Ⅰ;14 ceses (35%) to grade II;8 cases(20%) to grade Ⅲ;6 cases (15%) to grade IV.Treatment: 35 of 40 cases were chemotherapied with combined medicine.The total effeceive rate was 54.3%.Conclusion:LCH is a non tumor disease and its clinical presenation is various.Children often suffer from LCH and are often misdiagnosised.Suspicious patients can be diagnosed by impressed skin rash slide;mass aspirate,and finding langherhans cell.
出处
《江西医学院学报》
2003年第1期71-72,共2页
Acta Academiae Medicinae Jiangxi
