原发性宫颈恶性淋巴瘤的诊断、综合治疗和预后分析

发布时间：2018-11-07 19:18

【摘要】：目的：将探讨我院原发性宫颈恶性淋巴瘤(primary cervical lymphoma, PCL)的病理亚型,分期和临床表现特征、诊断手段、综合治疗及影响生存预后的因素,进一步了解宫颈淋巴瘤的临床病理特性,以探讨综合治疗手段在宫颈原发性恶性淋巴瘤治疗中的优化模式及预后。材料与方法：本研究为临床资料回顾性分析,本研究通过入组1992年12月～2009年8月37例我院收治的原发性宫颈恶性淋巴瘤患者。对所有符合入组标准的患者,记录患者的一般信息、随访患者目前的病情。所有患者都详细询问病史、体检、血常规、肝肾功能、胸片、腹部B超或Computed Tomography(CT)检查,除外非宫颈原发淋巴瘤累及宫颈,必要时行骨髓穿刺或活检,病理诊断都经我院病理科行免疫组化确诊。最后对所获取的数据进行统计分析。应用SPSS17.0软件包建立数据库,生存率采用Kaplan-Meier方法计算,应用x2检验分析,P0.05为差异有统计学意义,分析宫颈恶性淋巴瘤的临床特征、治疗及预后。结果：37例原发性宫颈恶性淋巴瘤患者有36例完成了临床随访(随访率97.3%),36例患者随访至2013年3月共33例存活,3例死亡,4例复发。到目前为止,中位随访时间67.5个月(2-204)个月,中位总生存期(Overall Survival, OS):87个月,中位无病生存期(Disease Free Survival, DFS):67.5个月(2-204个月)。5年生存率94.3%,10年生存率90.7%。结论：本病需与宫颈慢性炎性反应、宫颈淋巴瘤样病变、宫颈癌及子宫颈原发未分化小细胞癌(神经内分泌癌)相鉴别。原发性宫颈恶性淋巴瘤的治疗包括手术、放疗、化疗及免疫治疗,通常预后较好。临床分期越早预后越好,MALT淋巴瘤比其他类型淋巴瘤预后好。本病的发生可能与遗传因素有关。临床分期、病理分型及治疗方法等是预后的影响因素。
[Abstract]:Objective: to investigate the pathological subtypes, staging, clinical features, diagnostic methods, comprehensive treatment and factors affecting survival and prognosis of primary cervical malignant lymphoma (primary cervical lymphoma, PCL) in our hospital. To investigate the clinicopathological characteristics of cervical lymphoma and to explore the optimal treatment mode and prognosis of cervical primary malignant lymphoma. Materials and methods: this study was a retrospective analysis of clinical data. From December 1992 to August 2009 37 patients with primary cervical malignant lymphoma were treated in our hospital. For all patients who meet the admission criteria, record general information of the patient and follow up the patient's current condition. All patients were asked for medical history, physical examination, blood routine examination, liver and kidney function, chest radiography, abdominal B-ultrasound or Computed Tomography (CT) examination, except non-cervical primary lymphoma involving the cervix, bone marrow puncture or biopsy, when necessary, The pathological diagnosis was confirmed by immunohistochemistry in our department of pathology. Finally, the obtained data are statistically analyzed. The survival rate was calculated by Kaplan-Meier method and analyzed by x2 test. The difference was statistically significant (P0.05). The clinical features, treatment and prognosis of cervical malignant lymphoma were analyzed. Results: 36 cases (97.3%) of 37 patients with primary malignant lymphoma of cervix were followed up. 33 cases survived, 3 cases died and 4 cases recurred. So far, median follow-up time was 67.5 months (2-204) months, median total survival time (Overall Survival, OS):) was 87 months, median disease-free survival period (Disease Free Survival,) was 87 months. DFS): was 67.5 months (2-204 months). The 5-year survival rate was 94. 3 months, and the 10-year survival rate was 90. 7%. Conclusion: this disease should be distinguished from chronic inflammatory reaction of cervix, lymphomatous lesion of cervix, cervical carcinoma and primary undifferentiated small cell carcinoma of cervix (neuroendocrine carcinoma). The treatment of primary malignant lymphoma of the cervix includes surgery, radiotherapy, chemotherapy and immunotherapy. The earlier the clinical stage, the better the prognosis. MALT lymphoma has a better prognosis than other types of lymphoma. The occurrence of this disease may be related to genetic factors. Clinical staging, pathological classification and treatment are the prognostic factors.
【学位授予单位】：复旦大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R737.33

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