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韩国人群眼附属器淋巴增生性病变患者的预后

Prognosis for patients in a Korean population with ocular adnexal lymphoproliferative lesions.

作者信息

Yoon Jin Sook, Ma Kyoung Tak, Kim Sung Joo, Kook Kyunghoon, Lee Sang Yeul

机构信息

Department of Ophthalmology, Yonsei Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea.

出版信息

Ophthalmic Plast Reconstr Surg. 2007 Mar-Apr;23(2):94-9. doi: 10.1097/IOP.0b013e318030b058.

Abstract

PURPOSE

To analyze the clinical features, treatment outcomes, and prognostic factors associated with lymphoproliferative lesions of the ocular adnexa in a Korean population.

METHODS

Data from 69 patients treated for adnexal lymphoproliferative disease in the 12-year period from 1991 to 2002 were retrospectively evaluated.

RESULTS

The 69 patients had a median age of 46 years (range, 15-73 years); 60 of these patients were diagnosed with extranodal marginal zone B cell lymphomas (MALT lymphomas) and had 10 year cause specific survival and relapse free survival rates of 95.6% and 82.6%, respectively. Of 6 patients (8.7%) with concurrent systemic lymphoma, including 4 diagnosed with stage IV disease, 3 died from lymphoma. Only one patient with a primary ocular adnexal MALT lymphoma developed systemic lymphoma, which was treated with surgical resection. Local recurrence either at the primary site or in the fellow eye occurred in 11.6% of patients at a median follow-up time of 102 months (range, 79-132 months), and was controlled using repeat irradiation in all cases. Statistical analysis showed the presence of concurrent systemic lymphoma, bilateral disease, and an advanced stage at diagnosis, were linked to lymphoma-related death (Log-rank test, p < 0.05) and systemic progression (Fisher's exact test, p < 0.05), and that the tumor location was not a prognostic factor for lymphoma-related death or relapse at any site.

CONCLUSIONS

Ocular adnexal lymphoproliferative disease in Koreans occurred at a relatively young age, and was mostly orbitally located and of the MALT subtype, which is highly localized and rarely associated with extraorbital relapse. Primary or secondary status, stage at presentation, and bilaterality were found to be prognostic factors.

摘要

目的

分析韩国人群眼附属器淋巴增殖性病变的临床特征、治疗效果及预后因素。

方法

回顾性评估1991年至2002年12年间69例接受眼附属器淋巴增殖性疾病治疗患者的数据。

结果

69例患者的中位年龄为46岁(范围15 - 73岁);其中60例被诊断为结外边缘区B细胞淋巴瘤(黏膜相关淋巴组织淋巴瘤),其10年病因特异性生存率和无复发生存率分别为95.6%和82.6%。6例(8.7%)合并系统性淋巴瘤的患者中,包括4例诊断为IV期疾病的患者,3例死于淋巴瘤。仅1例原发性眼附属器黏膜相关淋巴组织淋巴瘤患者发生系统性淋巴瘤,接受了手术切除治疗。在中位随访时间102个月(范围79 - 132个月)时,11.6%的患者在原发部位或对侧眼出现局部复发,所有病例均通过重复放疗得到控制。统计分析显示,合并系统性淋巴瘤、双侧病变以及诊断时处于晚期与淋巴瘤相关死亡(对数秩检验,p < 0.05)和系统性进展(Fisher精确检验,p < 0.05)相关,且肿瘤位置不是淋巴瘤相关死亡或任何部位复发的预后因素。

结论

韩国人的眼附属器淋巴增殖性疾病发病年龄相对较轻,大多位于眼眶,为黏膜相关淋巴组织亚型,高度局限,很少与眶外复发相关。发现原发或继发状态、就诊时分期及双侧性为预后因素。

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