纵隔大B淋巴瘤22例临床分析(1)
[摘要] 目的 对纵隔大B淋巴瘤(primary mediastinal large B-cell lymphoma，PMBCL)的临床表现、诊治方法及预后进行系统剖析。 方法 收集1996年7月～2013年1月我院胸外科接治的22例经病理确诊为纵隔大B淋巴瘤患者的临床资料，进行回顾性分析和研究，并依照是否采取手术分成手术组(12例)和保守组(10例)，对两组生存情况进行比较分析。 结果 本组22例患者的平均生存时间为(43.6±3.7)个月，3年生存率达54.5%；手术组和保守组患者的生存期、3年生存率差异均无统计意义(P>0.05)；此外，手术组有6例患者术前合并上腔静脉综合征，手术后有明显改善；保守组有2例术前合并上腔静脉综合征，连续化疗2～3周期后得以缓解。 结论 对于PMBCL患者，手术的切除率不高，且对生存期无明显影响，但可在近期有效缓解上腔静脉综合征，且可作出更为准确、全面的病理诊断。
[关键词] 纵隔；大B细胞；淋巴瘤；临床特征
[中图分类号] R734.5 [文献标识码] B [文章编号] 1673-9701(2016)27-0049-03
Clinical analysis of 22 cases of mediastinal large B lymphoma
WANG Kunyu1 TONG Xiangdong2 QU Jiaqi2 WANG Shumin2 MENG Fanwu1 HAO Chunyang1
1.Department of Thoracic Surgery， Anshan Central Hospital in Liaoning Province， Anshan 114001， China； 2.Department of Thoracic Surgery， the General Hospital of Shenyang Military， Shenyang 110015， China
[Abstract] Objective To systematically analyze the clinical manifestation， diagnosis and treatment， and prognosis of primary mediastinal large B-cell lymphoma(PMBCL). Methods The clinical data of 22 patients with PMBCL who were admitted to the Department of Thoracic Surgery in our hospital and diagnosed by pathology were collected from July 1996 to January 2013 and retrospectively analyzed and studied. They were assigned to the operation group(12 cases) and conservative group (10 cases) according to whether the operation was performed， and the survival of the two groups was compared and analyzed. Results The average survival time in the 22 patients was(43.6±3.7) months， and the 3-year survival rate was 54.5%； the survival time and 3-year survival rate of the patients in the operation group and the conservative group were not significantly different (P>0.05). In addition， 6 patients in the operation group were complicated with superior vena cava syndrome before operation and improved after operation. 2 patients in the conservative group were complicated with superior vena cava syndrome before operation， and the symptoms were alleviated after continuous chemotherapy for 2 to 3 cycles. Conclusion For PMBCL patients， surgical resection rate is not high， and the surgery has no significant effect on survival. But it can effectively relieve the superior vena cava syndrome in a short term， and can make a more accurate and comprehensive pathological diagnosis.
[Key words] Mediastinum； Large B cells； Lymphoma； Clinical characteristics
纵隔大B淋巴瘤(primary mediastinal large B-cell lymphoma，PMBCL)是临床上较为少见的恶性肿瘤，属于弥漫大B细胞淋巴瘤的一个主要类型[1]。现阶段，临床普遍认为该肿瘤发生于胸腺内髓质B细胞，其在世卫组织明确的恶性淋巴瘤中是相对罕见一种，其发生率在所有非霍奇金淋巴瘤中仅占1.5%～3.0%，而在弥漫大B淋巴瘤中占6%～10%[2-3]。该病多发于年轻女性群体，原发性PMBCL的临床表现主要是局部侵袭[4]。当前，还尚未发现和找出特异性危险因素。为此，本文对我院近年来收治的22例纵隔大B淋巴瘤患者的临床资料回顾分析，探讨临床胸外科术在治疗中的价值，现报道如下。, 百拇医药(王坤宇 童向东 曲家骐 王述民 孟凡武 郝春阳)
[关键词] 纵隔；大B细胞；淋巴瘤；临床特征
[中图分类号] R734.5 [文献标识码] B [文章编号] 1673-9701(2016)27-0049-03
Clinical analysis of 22 cases of mediastinal large B lymphoma
WANG Kunyu1 TONG Xiangdong2 QU Jiaqi2 WANG Shumin2 MENG Fanwu1 HAO Chunyang1
1.Department of Thoracic Surgery， Anshan Central Hospital in Liaoning Province， Anshan 114001， China； 2.Department of Thoracic Surgery， the General Hospital of Shenyang Military， Shenyang 110015， China
[Abstract] Objective To systematically analyze the clinical manifestation， diagnosis and treatment， and prognosis of primary mediastinal large B-cell lymphoma(PMBCL). Methods The clinical data of 22 patients with PMBCL who were admitted to the Department of Thoracic Surgery in our hospital and diagnosed by pathology were collected from July 1996 to January 2013 and retrospectively analyzed and studied. They were assigned to the operation group(12 cases) and conservative group (10 cases) according to whether the operation was performed， and the survival of the two groups was compared and analyzed. Results The average survival time in the 22 patients was(43.6±3.7) months， and the 3-year survival rate was 54.5%； the survival time and 3-year survival rate of the patients in the operation group and the conservative group were not significantly different (P>0.05). In addition， 6 patients in the operation group were complicated with superior vena cava syndrome before operation and improved after operation. 2 patients in the conservative group were complicated with superior vena cava syndrome before operation， and the symptoms were alleviated after continuous chemotherapy for 2 to 3 cycles. Conclusion For PMBCL patients， surgical resection rate is not high， and the surgery has no significant effect on survival. But it can effectively relieve the superior vena cava syndrome in a short term， and can make a more accurate and comprehensive pathological diagnosis.
[Key words] Mediastinum； Large B cells； Lymphoma； Clinical characteristics
纵隔大B淋巴瘤(primary mediastinal large B-cell lymphoma，PMBCL)是临床上较为少见的恶性肿瘤，属于弥漫大B细胞淋巴瘤的一个主要类型[1]。现阶段，临床普遍认为该肿瘤发生于胸腺内髓质B细胞，其在世卫组织明确的恶性淋巴瘤中是相对罕见一种，其发生率在所有非霍奇金淋巴瘤中仅占1.5%～3.0%，而在弥漫大B淋巴瘤中占6%～10%[2-3]。该病多发于年轻女性群体，原发性PMBCL的临床表现主要是局部侵袭[4]。当前，还尚未发现和找出特异性危险因素。为此，本文对我院近年来收治的22例纵隔大B淋巴瘤患者的临床资料回顾分析，探讨临床胸外科术在治疗中的价值，现报道如下。, 百拇医药(王坤宇 童向东 曲家骐 王述民 孟凡武 郝春阳)