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摘要: 目的 探讨CD20阳性的结外鼻型NK/T细胞淋巴瘤(ENKTL)的临床特征及预后。方法 对11例ENKTL患者的临床特征及预后进行分析。结果 11例患者中, 乳酸脱氢酶升高者6例, 贫血者6例, Ki-67≥50%者8例, 2例随访中; 1例失联; 8例死亡, 平均生存时间为22.5个月。结论 CD20阳性的ENKTL诊断存在困难, 需联合病理形态学、免疫组织化学、EBER及基因重排检测, 提高对该病的认识, 早期诊断, 积极治疗。Abstract: Objective To explore the clinical features and prognosis of CD20-positive extranodal NK/T cell lymphoma.Methods To analyze the clinical characteristics and prognosis of 11 ENKTL patients admitted to this hospital.Results Among the 11 patients, 6 cases with elevated LDH, 6 cases of anemia, and 8 cases with Ki-67≥50%. Two cases survived; 1 case lost contact; 8 cases died, and the average survival time of 8 cases was 22.5 months.Conclusion The diagnosis of CD20 positive ENKTL is difficult, which requires a combination pathomorphology, immunohistochemistry, EBER and gene rearrangement detection and improve the understanding of the disease.Early diagnosis and active treatment is important.
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Key words:
- nose neoplasms /
- CD20 /
- immunochemistry /
- pathology
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表 1 11例患者的临床资料
例序 性别 年龄/岁 分期 B症状 IPI评分 LDH/(U·L-) Β2微球蛋白/(mg·L-1) 贫血 EB-DNA 1 女 29 Ⅲ 有 2 187 0.69 有 阴性 2 男 74 Ⅳ 无 4 222 1.10 无 阳性 3 男 79 Ⅰ 无 2 317↑ 1.11 无 阴性 4 男 36 Ⅱ 有 1 141 1.25 无 阴性 5 男 72 Ⅱ 无 2 210 1.01 有 阴性 6 男 55 Ⅱ 有 2 327↑ 6.99↑ 无 阴性 7 女 43 Ⅰ 无 0 184 1.08 无 阴性 8 男 45 Ⅰ 有 1 276↑ 1.67 有 阴性 9 男 20 Ⅱ 有 2 424↑ 4.98↑ 有 阴性 10 男 50 Ⅱ 无 1 269↑ 1.21 有 阴性 11 男 41 Ⅰ 无 1 330↑ 0.89 有 阴性 
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表 2 11例患者的病理结果
例序 CK CD3 CD20 CD30 CD21 CD43 PAX-5/CD79a Bcl-2 CD56 TIA-1 Ki-67/% EBER 1 + + + / - + - / + + 30 + 2 + + + + - + - + + + 70 + 3 - + + + - + / / + + 80 + 4 - + + + - + - - + + 80 + 5 - + + - - + - / + + 50 + 6 + + + + - + - / + + 90 + 7 + + + + - + / / + + 10 + 8 + + + - - + - / + + 50 + 9 + + + + - / - / + + 70 + 10 + + + / - + - / + + 30 + 11 - + + - - + - / + + 70 + 注：“+”阳性表达；“-”阴性表达；“/”病理诊断未显示。
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表 3 11例患者治疗及随访情况
例序 治疗方式 首次疗效 随访时间/月 结局 死亡原因 1 DDGP5周期 进展 9 死亡 肿瘤进展 2 放疗50 Gy，2 Gy；DDGP6周期 部分缓解 21 死亡 肿瘤进展 3 SMILE3周期；PD-1单抗 部分缓解 12 死亡 肿瘤进展 4 放疗60 Gy；DDGP4周期 部分缓解 26 死亡 肿瘤进展 5 放疗60 Gy 完全缓解 18 存活 - 6 E-CHOP4周期；放疗60 Gy 部分缓解 - 失联 - 7 DDGP6周期；放疗50 Gy 完全缓解 24 死亡 肿瘤进展 8 DDGP5周期；放疗60 Gy 部分缓解 30 死亡 肿瘤进展 9 DDGP6周期；放疗60 Gy 完全缓解 17 存活 - 10 E-CHOP5周期；放疗50 Gy 部分缓解 24 死亡 肿瘤进展 11 DDGP6周期；放疗60 Gy 完全缓解 34 死亡 肿瘤进展
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