37例原发甲状腺淋巴瘤的临床病理特征及疗效分析

周玥; 许霞; 徐欢; 崔国惠; 张璐

doi:10.13201/j.issn.1001-1781.2018.20.005

37例原发甲状腺淋巴瘤的临床病理特征及疗效分析

- 1. 华中科技大学同济医学院附属协和医院耳鼻咽喉科(武汉, 430022);
- 2. 华中科技大学同济医学院附属协和医院病理科;
- 3. 华中科技大学同济医学院附属协和医院血液病研究所
基金项目:
国家自然科学基金 (No:81400172)

详细信息

通讯作者: 张璐, E-mail:luluzhang103@hotmail.com

中图分类号: R733.4

收稿日期: 2018-08-22

Clinicopathological features and treatment outcome of 37 cases of primary thyroid lymphoma

- 1 Department of Otolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China;
- 2 Department of Pathology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology;
- 3 Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology

More Information

Corresponding author: ZHANG Lu, E-mail: luluzhang103@hotmail.com

Received Date: 22 August 2018

摘要

摘要: 目的: 探讨原发性甲状腺淋巴瘤(PTL)的临床病理特征和疗效。方法: 回顾性分析37例PTL患者的临床和病理资料,结合随访资料进行分析。结果: 37例患者中75.7%合并桥本甲状腺炎。术前粗针穿刺活检的淋巴瘤检出率为75%,明显优于穿刺细胞学的检出率(53%);病理类型包括弥漫大B细胞淋巴瘤23例(弥漫大B细胞淋巴瘤伴有黏膜相关淋巴组织结外边缘区淋巴瘤成分6例),黏膜相关淋巴组织结外边缘区淋巴瘤10例,3级滤泡淋巴瘤3例,伯基特淋巴瘤1例。Ann Arbor分期ⅠE期12例,ⅡE期25例。随访2~93个月,3年总体生存率和无进展生存率分别为87.0%和81.6%,5年总体生存率和无进展生存率分别为79.8%和74.8%。单因素生存分析发现综合治疗是影响预后的重要因素,而年龄、性别、乳酸脱氢酶、水平、β2-微球蛋白、Ann Arbor分期、国际预后指数、组织亚型对生存的影响差异无统计学意义。结论: PTL常见于合并桥本甲状腺炎的中老年女性,总体预后较好。粗针穿刺活检阳性率较高,以放疗或(和)化疗为基础、手术为辅助的综合治疗能提高患者的疗效。
- 甲状腺 /
- 淋巴瘤 /
- 综合治疗 /
- 疗效 /
- 预后
Abstract: Objective: The aim of this study is to explore the clinicopathological features and treatment outcome of primary thyroid lymphoma(PTL).Method: Clinicopathological data of 37 cases of PTL were retrospectively reviewed, and analyzed in combined with follow-up data.Result: Of the 37 patients, Hashimoto's disease was diagnosed in 28(75.7%) patients. The diagnostic rate of preoperative fine needle biopsy (75%) was higher than the fine needle aspiration (53%). The pathological types of these patients included diffuse large B cell lymphoma(n=23), extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue type (MALT) (n=10), follicular lymphoma(FL) grade 3 (n=3) and burkitt lymphoma(BL) (n=1). According to Ann Arbor staging system, 12 patients with stage ⅠE, and 25 patients with stage ⅡE. With a median follow-up period of 37 months (2-93 months), the 3-year overall survival (OS) rate and progression free survival(PFS) was 87.0% and 81.6%, and 5-year overall survival(OS) rate and PFS was 79.8% and 74.8%. Univariate survival analysis found that comprehensive treatment was an important factor affecting prognosis, but there was no statistical difference in the effects of age, gender, lactate dehydrogenase, level, β2 microglobulin, Ann Arbor staging, international prognostic index, and tissue subtype on survival (P>0.05).Conclusion: PTL mostly affects middle aged and old female and has a favorable prognosis. Core needle biopsy can improve the diagnostic rate when compared with fine needle aspiration. The optimal treatment is combined modality strategy based on chemotherapy and radiotherapy, and supplemented by surgery.
- thyroid gland /
- lymphoma /
- combined modality treatment /
- treatment outcome /
- prognosis

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