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目的非霍奇金淋巴瘤(non-hodgkin’s lymphoma,NHL)是严重威胁人类健康和生命的恶性肿瘤之一,各年龄段均可发病,具有高度异质性,不同病理亚型的临床特征有很大差异。本研究调查云南地区NHL患者的临床病理特征,为本地区开展NHL临床诊疗及防治工作提供参考。方法回顾性分析云南省肿瘤医院2003-01-01-2012-12-31收治的NHL患者的临床病理资料。结果共计1 326例NHL纳入统计,男女比例为1.6∶1;年龄4~85岁,中位年龄50岁。全组患者中B细胞淋巴瘤为933例(70.4%),T细胞淋巴瘤为361例(27.2%),两者比例为2.6∶1;以弥漫大B细胞淋巴瘤(34.7%,460/1 326)、结外NK/T细胞淋巴瘤鼻型(9.1%,121/1 326)、外周T细胞淋巴瘤(6.4%,85/1 326)、滤泡性淋巴瘤(5.8%,77/1 326)及结外粘膜相关淋巴组织边缘区淋巴瘤(4.8%,63/1 326)最常见。淋巴结起病者占45.8%(607/1 326),最常见为颈部及锁骨上淋巴结(27.3%,362/1 326);结外起病者占50.3%(667/1 326),常见部位依次为胃肠道(10.9%,144/1 326)、韦氏环(10.6%,141/1 326)及鼻腔(10.5%,139/1 326)。全组患者Ⅰ、Ⅱ期占54.8%(726/1 326),Ⅲ、Ⅳ期占45.2%(600/1 326)。单因素分析显示,病理类型、侵袭性分级、起病部位、节外淋巴瘤、B症状、ECOG评分、血清LDH水平和大肿块为NHL临床分期的影响因素。多因素分析结果显示,病理类型、侵袭性分级、起病部位、B症状、ECOG评分、血清LDH水平和大肿块为NHL临床分期的影响因素。结论云南地区NHL发病以中年人为主,男性多于女性,B细胞淋巴瘤显著多于T细胞淋巴瘤,结外起病者略高于结内起病者,病理恶性程度、起病部位、全身症状、体能状态评分、血清乳酸脱氢酶水平和大肿块对临床分期有明显影响。
Objective Non-hodgkin’s lymphoma (NHL) is one of the most serious malignant tumors that threaten human health and life. It has a high degree of heterogeneity and clinical features in different pathological subtypes Big difference. This study investigated the clinicopathological features of patients with NHL in Yunnan and provided references for the clinical diagnosis and treatment of NHL in this area. Methods Retrospective analysis of Yunnan Provincial Tumor Hospital in 2003-01-01-2012-12-31 clinical data of patients with NHL. Results A total of 1 326 cases of NHL were included in the statistics. The male-female ratio was 1.6:1. The age ranged from 4 to 85 years and the median age was 50 years. There were 933 (70.4%) B-cell lymphomas and 361 (27.2%) T-cell lymphomas in both groups, with a ratio of 2.6: 1; diffuse large B cell lymphoma 326), extranodal NK / T cell lymphoma (9.1%, 121/1 326), peripheral T cell lymphoma (6.4%, 85/1 326), follicular lymphoma (5.8%, 77/1 326) and extranodal mucosa-associated lymphoid marginal zone lymphoma (4.8%, 63/1 326) were the most common. The incidence of lymph nodes accounted for 45.8% (607/1 326), the most common of the neck and supraclavicular lymph nodes (27.3%, 362/1 326); extranodal onset accounted for 50.3% (667/1 326), common sites Followed by gastrointestinal tract (10.9%, 144/1 326), Wechsler ring (10.6%, 141/1 326) and nasal cavity (10.5%, 139/1 326). The whole group of patients Ⅰ, Ⅱ accounted for 54.8% (726/1 326), Ⅲ, Ⅳ accounted for 45.2% (600/1 326). Univariate analysis showed that pathological type, invasive grade, site of onset, extralymphatic lymphoma, B symptom, ECOG score, serum LDH level and large mass were the influencing factors of clinical stage of NHL. Multivariate analysis showed that pathological type, invasive grade, onset site, B symptom, ECOG score, serum LDH level and large mass were the influencing factors of clinical stage of NHL. Conclusions The incidence of NHL in Yunnan Province is mainly middle-aged, more than men, and B-cell lymphoma is significantly more than T-cell lymphoma. The incidence of NHL in Yunnan is slightly higher than that in the onset of node, pathological malignancy, Systemic symptoms, physical status scores, serum lactate dehydrogenase levels and large masses have a significant effect on clinical stage.