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鼻腔外 NK/T 细胞淋巴瘤的临床特征和预后模型。

Clinical features and prognostic model for extranasal NK/T-cell lymphoma.

机构信息

Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.

出版信息

Eur J Haematol. 2012 Aug;89(2):103-10. doi: 10.1111/j.1600-0609.2012.01796.x.

Abstract

OBJECTIVE

The clinical features of extranodal natural killer (NK)/T-cell lymphoma (ENKL) that originates in extranasal sites are less well defined than those of ENKL that originates in nasal sites. Therefore, we compared the clinical characteristics and prognoses of patients with nasal ENKL and patients with extranasal ENKL.

METHODS

We retrospectively analyzed 117 consecutive patients with ENKL that included 89 (76.1%) with nasal and 28 (23.9%) with extranasal disease.

RESULTS

Extranasal ENKL was associated with more adverse clinical features than nasal ENKL, which included the presence of B symptoms, stage III/IV disease, ≥2 extranodal sites, and involvement of regional lymph nodes and bone marrow. After a median follow-up of 33.1 months (range, 0.7-152.2 months), the median overall survival (OS) of patients with extranasal and nasal NK/T-cell lymphoma was 8.6 and 86.5 months, respectively. Multivariate analysis revealed that extranasal NK/T-cell lymphoma was a significant factor that affects OS. When patients with extranasal ENKL were classified into low-risk and high-risk categories according to the Korean Prognostic Index (KPI) and International Prognostic Index (IPI), these indices categorized the two groups with significantly different survival outcomes (P = 0.025 and 0.035, respectively).

CONCLUSIONS

Patients with extranasal ENKL have worse clinical outcomes than those with nasal ENKL. The KPI and IPI appear useful for the prognosis of patients with extranasal ENKL.

摘要

目的

与鼻型结外自然杀伤(NK)/T 细胞淋巴瘤(ENKL)相比,发生于鼻外部位的 ENKL 的临床特征尚不明确。因此,我们比较了鼻型 ENKL 患者和鼻外型 ENKL 患者的临床特征和预后。

方法

我们回顾性分析了 117 例连续的 ENKL 患者,其中 89 例(76.1%)为鼻型,28 例(23.9%)为鼻外型。

结果

鼻外型 ENKL 与更差的临床特征相关,包括 B 症状、III/IV 期疾病、≥2 个结外部位、累及区域淋巴结和骨髓。中位随访 33.1 个月(范围 0.7-152.2 个月)后,鼻外型和鼻型 NK/T 细胞淋巴瘤患者的中位总生存(OS)分别为 8.6 和 86.5 个月。多因素分析显示,鼻外型 NK/T 细胞淋巴瘤是影响 OS 的显著因素。当根据韩国预后指数(KPI)和国际预后指数(IPI)将鼻外型 ENKL 患者分为低危和高危组时,这两个指数将两组患者的生存结果明显区分(P=0.025 和 0.035)。

结论

鼻外型 ENKL 患者的临床结局较鼻型 ENKL 患者差。KPI 和 IPI 似乎对鼻外型 ENKL 患者的预后有用。

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