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本文回顾分析1973年12月～1976年12月间收治的非何杰金氏淋巴瘤(NHL)80例。按 Rappa-port 分类法计结节型15例(分化良好性1例,低分化性14例)弥漫型65例(分化良好型13例,低分化性49例,混合细胞性2例,组织细胞性1例)。临床分期采用 Ann Arbor 法,计Ⅰ期25例,Ⅱ期23例,Ⅲ期25例,Ⅳ期7例。治疗以化疗、放疗为主;化疗均用 COP 为主的类似方案;放疗用~(60)钴照射,每野3,000～4,000rad。本组病人5年生存率27.5％(22/80),包括无瘤生存9例,带瘤生存13例。女性病人缓解率、生存率与男性病人近似。20岁以下的病人缓解率、生存率稍高于20岁以上的病人。临床Ⅰ期的病人缓解率88.8％,Ⅱ期82.6％,Ⅲ期64.0％,Ⅳ期57.1％。Ⅰ期病人5年生存率40％,Ⅱ期30.4％,Ⅲ期20％,Ⅳ期无1例生存到5年。故缓解率、生存率按分期顺序递减。本病首发于淋巴结者的缓解率、生存率均高于结外病变者。结内以首发浅表淋巴结者预后较好。达 CR 的病人5年生存率(50％)高于 PR(30％),NR 组病人无1例生存到5年。按病理类型分类,结节型病人的预后比弥漫型病人好。弥漫型中的细胞分化程度越差,缓解率与5年生存率越低。DLWD 的缓解率84.6％,DLPD73.4％,D-MC50％,D-HLY 无1例生存到5年。各细胞分类的5年生存率 DLWD61.5％,NLPD35.7％,DLPD18.3％。其 DLWD 生存率最高。NLPD 的 CR 率88.8％高于 DLPD24.4％。NLPD 中位缓解期63天,中位生存期2年,均高于 DLPD 的54天与1.5年。NLPD 5年生存率35.5％高于 DLPD18.3％。本组中混合细胞型和组织细胞型的例数少,有待于今后临床工作中进一步探讨。
This article reviews 80 cases of non-Hodgkin’s lymphoma (NHL) treated between December 1973 and December 1976. According to the Rappa-port classification method, there were 15 nodular types (one with well-differentiated and 14 with poorly-differentiated) and 65 diffused cases (13 well-differentiated, 49 poorly-differentiated, 2 mixed-cell, and histiocytes). Sexual 1 case). The clinical stage was Ann Arbor method, including 25 cases of stage I, 23 cases of stage II, 25 cases of stage III, and 7 cases of stage IV. Chemotherapy and radiotherapy were the main treatments. Chemotherapy was used for the similar COP-based regimen. Radiotherapy was performed with ~(60)cobalt radiation at 3,000 to 4,000 rad per field. The 5-year survival rate of this group of patients was 27.5% (22/80), including 9 cases of tumor free survival and 13 cases of tumor survival. The remission rate and survival rate of female patients are similar to those of male patients. The remission rate and survival rate of patients under the age of 20 are slightly higher than those above 20 years of age. The remission rate was 88.8% for patients with clinical stage I, 82.6% for stage II, 64.0% for stage III, and 57.1% for stage IV. The 5-year survival rate of patients in stage I was 40%, 30.4% in stage II, and 20% in stage III. None of the patients in stage IV survived to 5 years. Therefore, the remission rate and survival rate decrease in the order of stages. The disease’s remission rate and survival rate were higher in lymph node than in those with extranodal changes. Patients with first superficial lymph nodes have a better prognosis. The 5-year survival rate (50%) of CR patients was higher than PR (30%), and none of the NR patients survived to 5 years. According to pathological classification, the prognosis of nodular patients is better than that of diffuse patients. The worse the degree of cell differentiation in the diffuse type, the lower the remission rate and 5-year survival rate. The remission rate of DLWD was 84.6%, DLPD was 73.4%, D-MC was 50%, and none of D-HLY survived to 5 years. The 5-year survival rate for each cell classification was 61.5% for DLWD, 35.7% for NLPD, and 18.3% for DLPD. Its DLWD has the highest survival rate. The NLPD CR rate was 88.8% higher than DLPD 24.4%. The median remission period for NLPD was 63 days, and the median survival period was 2 years, which was higher than the DLPD of 54 days and 1.5 years. The 5-year survival rate of NLPD is 35.5% higher than DLPD18.3%. The number of cases of mixed cell types and histiocytic cell types in this group is small and needs to be further explored in future clinical work.