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分析 142 例中国北方外周 T/NK 细胞淋巴瘤患者:亚型分布、临床病理特征和预后。

Analysis of 142 Northern Chinese patients with peripheral T/NK-Cell lymphomas: subtype distribution, clinicopathologic features, and prognosis.

机构信息

Department of Pathology, Peking University First Hospital, Beijing, China.

出版信息

Am J Clin Pathol. 2012 Sep;138(3):435-47. doi: 10.1309/AJCPWKJ3GPFRT7GA.

DOI:10.1309/AJCPWKJ3GPFRT7GA
PMID:22912362
Abstract

Peripheral T- and natural killer (NK)-cell lymphomas (PTNKLs) are a heterogeneous group of lymphoid malignancies. We reclassified 142 cases and investigated their clinicopathologic features and outcome. Results showed that the most prevalent subtypes were extranodal NK/T-cell lymphoma, nasal type (eNK/T) (38.0%); angioimmunoblastic T-cell lymphoma (16.9%); and peripheral T-cell lymphoma, not otherwise specified (16.2%). Follow-up was available in 124 patients whose overall survival ranged from 3 days to 134 months, with a median of 11 months. Multivariate analysis demonstrated that thrombocytopenia (P = .001), elevated lactate dehydrogenase (P = .007), high Ki-67 index (P = .002), and T-bet expression in more than 20% of cells (P = .036) were independent factors for all cases-among which only the factor of T-bet indicated good outcome-and that thrombocytopenia (P = .011) and radiotherapy (P = .026) were significant for the eNK/T group. Thus, eNK/T was the commonest subtype in this series. The significance of T-bet in predicting outcome should be further confirmed.

摘要

外周 T 细胞和自然杀伤(NK)细胞淋巴瘤(PTNKLs)是一组异质性的淋巴恶性肿瘤。我们重新分类了 142 例病例,并研究了其临床病理特征和结局。结果显示,最常见的亚型是结外 NK/T 细胞淋巴瘤,鼻型(eNK/T)(38.0%);血管免疫母细胞性 T 细胞淋巴瘤(16.9%);和外周 T 细胞淋巴瘤,非特指型(16.2%)。在可进行随访的 124 例患者中,总生存期从 3 天至 134 个月不等,中位生存期为 11 个月。多因素分析表明,血小板减少(P =.001)、乳酸脱氢酶升高(P =.007)、Ki-67 指数高(P =.002)以及 T-bet 在超过 20%的细胞中表达(P =.036)是所有病例的独立预后因素——其中只有 T-bet 这一因素提示预后良好——而血小板减少(P =.011)和放疗(P =.026)对 eNK/T 组有显著影响。因此,在本系列中 eNK/T 是最常见的亚型。T-bet 在预测结局方面的意义需要进一步证实。

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