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[套细胞淋巴瘤:102例中国患者的临床病理特征及预后因素]

[Mantle cell lymphoma: clinicopathologic features and prognostic factors of 102 cases occurring in Chinese patients].

作者信息

Ji Hong, Li Gan-di, Li Feng-yuan, Bai Yan-qiong, Chen Yu, Yang Ming-zhong, Wang Lian-jun, Tang Yan, Zhang Pei, Xia Tian, Li Ci, Feng Jiang, Zou Zong-kai, Yixi Jia-cuo

机构信息

Department of Pathology, West China Hospital, Sichuan University, Chengdu 610041, China.

出版信息

Zhonghua Bing Li Xue Za Zhi. 2007 Nov;36(11):730-5.

Abstract

OBJECTIVE

To study the clinicopathologic features and prognostic factors of Chinese patients with mantle cell lymphoma.

METHODS

One hundred and two cases of mantle cell lymphoma occurring in Chinese patients were studied by light microscopy and immunohistochemistry. The follow-up information was also analyzed. The cases were classified as mantle zone, nodular or diffuse patterns and as typical or blastoid variants. Age, Ann-Arbor staging, B symptoms, hematologic parameters, histologic variants, mitotic index and immunophenotype were assessed for possible prognostic implication.

RESULTS

The median age of the patients was 59 years (range: 30 to 79 years) and the male-to-female ratio was 2.92:1. Seventy-one patients (87.65%) presented with advanced stage disease (Ann Arbor stage III to IV). B symptoms were present in 45.45% of patients. The commonest site of involvement was lymph node (100%). The other involved sites included bone marrow (64.44%), spleen (63.16%), Waldeyer's ring (31.25%), peripheral blood (29.41%), liver (22.64%) and gastrointestinal tract (14.71%). All cases expressed B-cell markers but were negative for T-cell marker. Majority of cases were positive for cyclin D1 (94.12%) and CD5 (71.43%). Blastoid variant accounted for 24.51% of cases. Amongst the 68 cases with follow-up data available, the median survival was 10 months. Parameters associated with shorter survival included diffuse pattern, blastoid variant, high mitotic index, high proliferative activity and presence of bone marrow involvement.

CONCLUSIONS

The clinicopathologic features and prognostic factors of mantle cell lymphoma occurring in Chinese are similar to those in Caucasians. Diffuse pattern, blastoid variant, high mitotic index, high proliferative activity and involvement of bone marrow indicate poor prognosis.

摘要

目的

研究中国套细胞淋巴瘤患者的临床病理特征及预后因素。

方法

对102例中国套细胞淋巴瘤患者进行光镜及免疫组化研究,并分析随访信息。病例分为套区、结节或弥漫型,以及典型或母细胞样变型。评估年龄、Ann-Arbor分期、B症状、血液学参数、组织学变型、有丝分裂指数及免疫表型以探讨其可能的预后意义。

结果

患者中位年龄59岁(范围:30至79岁),男女比例为2.92:1。71例(87.65%)患者为晚期疾病(Ann-Arbor分期III至IV期)。45.45%的患者有B症状。最常见的受累部位为淋巴结(100%)。其他受累部位包括骨髓(64.44%)、脾脏(63.16%)、韦氏环(31.25%)、外周血(29.41%)、肝脏(22.64%)及胃肠道(14.71%)。所有病例均表达B细胞标志物,但T细胞标志物为阴性。大多数病例cyclin D1阳性(94.12%),CD5阳性(71.43%)。母细胞样变型占病例的24.51%。在有随访数据的68例患者中,中位生存期为10个月。与生存期较短相关的参数包括弥漫型、母细胞样变型、高有丝分裂指数、高增殖活性及骨髓受累。

结论

中国套细胞淋巴瘤的临床病理特征及预后因素与白种人相似。弥漫型、母细胞样变型、高有丝分裂指数、高增殖活性及骨髓受累提示预后不良。

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