台湾单一家医院 303 例依据世界卫生组织分类系统分类的恶性淋巴瘤的临床病理分析。

The clinicopathological analysis of 303 cases with malignant lymphoma classified according to the World Health Organization classification system in a single institute of Taiwan.

机构信息

Division of Hematology, Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, Number 325, Section 2, Cheng-Kung Road, Neihu 114, Taipei, Taiwan.

出版信息

Ann Hematol. 2010 Jun;89(6):553-62. doi: 10.1007/s00277-009-0870-z. Epub 2009 Dec 11.

DOI:10.1007/s00277-009-0870-z

PMID:20012434

Abstract

Several reports have shown a different distribution of malignant lymphoma (ML) in Asian and Western populations. The purpose of our survey was to elucidate whether there are substantial differences in the frequencies of subtypes of ML between different geographical areas. All entities diagnosed as ML between June 1995 and December 2007 were selected according to the 2008 World Health Organization (WHO) classification and searched for clinical outcomes. The cases were retrieved and reviewed by a panel of clinical haematologists and haematopathologists. A total of 303 patients with ML were identified for retrospective analysis. Of the 303 patients with ML, 278 patients (91.7%) had non-Hodgkin's lymphoma (NHL), and 25 (9.2%) had Hodgkin's lymphoma. Of the 278 patients with NHL, 223 (73.6%) had lymphoma of B-cell lineage, and 55 (18.1%) had lymphoma of T-cell lineage. One hundred and thirty-seven patients were diagnosed with diffuse large B-cell lymphoma, which was the most common B-cell lineage subtype and accounted for 45.2% of patients with NHL. Peripheral T-cell lymphomas were the most frequent subset of the T-cell neoplasms, comprising 10.6% of ML. Extranodal involvement was found in 125 (44.9%) of the 278 patients with NHL, and the lymph node was the site of primary involvement in 153 patients (55.1%). Fifty-nine (47.2%) of the 125 patients with extranodal presentation had gastrointestinal tract involvement. Outcome was worse in patients with extranodal NHL than in those with nodal NHL through the entire follow-up period; the difference in survival rates was significant. Our findings clarify the applicability and prognostic relevance of the WHO classification system and provide further information about the incidence of various lymphoma subtypes in Taiwan. Primary extranodal NHL was associated with a worse prognosis and distinct characteristics compared with nodal NHL. The outcome of different types of extranodal NHL should be investigated further.

摘要

一些报告显示，恶性淋巴瘤（ML）在亚洲和西方人群中的分布不同。我们的调查目的是阐明不同地理区域间 ML 亚型的频率是否存在实质性差异。根据 2008 年世界卫生组织（WHO）分类，选择了 1995 年 6 月至 2007 年 12 月期间诊断为 ML 的所有实体，并对其临床结果进行了搜索。通过一组临床血液学家和血液病理学家对病例进行了检索和回顾。共对 303 例 ML 患者进行了回顾性分析。在 303 例 ML 患者中，278 例（91.7%）为非霍奇金淋巴瘤（NHL），25 例（9.2%）为霍奇金淋巴瘤。在 278 例 NHL 患者中，223 例（73.6%）为 B 细胞淋巴瘤，55 例（18.1%）为 T 细胞淋巴瘤。137 例诊断为弥漫性大 B 细胞淋巴瘤，这是最常见的 B 细胞谱系亚型，占 NHL 患者的 45.2%。外周 T 细胞淋巴瘤是 T 细胞肿瘤中最常见的亚群，占 ML 的 10.6%。278 例 NHL 患者中有 125 例（44.9%）有结外累及，153 例（55.1%）的原发病灶位于淋巴结。125 例结外表现患者中，59 例（47.2%）有胃肠道累及。整个随访期间，结外 NHL 患者的预后比结内 NHL 患者差，生存率差异有统计学意义。我们的研究结果阐明了 WHO 分类系统的适用性和预后相关性，并提供了台湾各种淋巴瘤亚型发病率的进一步信息。与结内 NHL 相比，原发性结外 NHL 具有更差的预后和不同的特征。应进一步研究不同类型的结外 NHL 的结局。