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Clinical impact of molecular features in diffuse large B-cell lymphoma and follicular lymphoma.弥漫性大 B 细胞淋巴瘤和滤泡性淋巴瘤中分子特征的临床意义。
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Expression of programmed cell death ligand 1 is associated with poor overall survival in patients with diffuse large B-cell lymphoma.程序性细胞死亡配体1的表达与弥漫性大B细胞淋巴瘤患者的总生存期较差相关。
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Immunohistochemical analysis indicates that the anatomical location of B-cell non-Hodgkin's lymphoma is determined by differentially expressed chemokine receptors, sphingosine-1-phosphate receptors and integrins.免疫组化分析表明，B 细胞非霍奇金淋巴瘤的解剖位置由差异表达的趋化因子受体、鞘氨醇-1-磷酸受体和整合素决定。
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Diffuse large B-cell lymphoma: sites of extranodal involvement are a stronger prognostic indicator than number of extranodal sites in the rituximab era.弥漫性大B细胞淋巴瘤：在利妥昔单抗时代，结外受累部位比结外部位数量是更强的预后指标。
Leuk Lymphoma. 2015 Jul;56(7):2047-55. doi: 10.3109/10428194.2014.982636. Epub 2015 Jan 14.
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Lenalidomide combined with R-CHOP overcomes negative prognostic impact of non-germinal center B-cell phenotype in newly diagnosed diffuse large B-Cell lymphoma: a phase II study.来那度胺联合 R-CHOP 克服了新诊断弥漫性大 B 细胞淋巴瘤中非生发中心 B 细胞表型的不良预后影响：一项 II 期研究。
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Institutional review of primary non-hodgkin lymphoma of the female genital tract: a 33-year experience.女性生殖道原发性非霍奇金淋巴瘤的机构性回顾：33年经验
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Helicobacter pylori-related diffuse large B-cell lymphoma of the stomach: a distinct entity with lower aggressiveness and higher chemosensitivity.幽门螺杆菌相关的胃弥漫性大B细胞淋巴瘤：一种侵袭性较低且化疗敏感性较高的独特实体。
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年轻弥漫性大B细胞淋巴瘤患者的结外受累：分布、预后价值及治疗选择

Extranodal involvement in young patients with diffuse large B-cell lymphoma: distribution, prognostic value and treatment options.

作者信息

Yao Shuna, Li Junbo, Yao Zhihua, Xu Yuanlin, Chu Junfeng, Zhang Jiuyang, Jin Shuiling, Huang Yangyang, Zhang Jianbo, Ma Jie, Zhao Yan, Yang Shujun, Liu Yanyan

机构信息

Department of Internal Medicine, Henan Cancer Hospital & Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou 450008, China.

Department of Internal Medicine, the Second Affiliated Hospital of Zhengzhou University, Zhengzhou 450014, China.

出版信息

Chin J Cancer Res. 2017 Feb;29(1):57-65. doi: 10.21147/j.issn.1000-9604.2017.01.07.

DOI:10.21147/j.issn.1000-9604.2017.01.07
PMID:28373754
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5348476/
Abstract

OBJECTIVE

Extranodal involvement represents a peculiar presentation of diffuse large B-cell lymphoma (DLBCL). Previous studies have suggested that older patients are more prone to extranodal involvement. This study retrospectively addressed the distribution, prognostic value and treatment options of extranodal involvement in young patients with DLBCL.

METHODS

A total of 329 patients were enrolled according to the inclusion requirements. The effects of gender, extranodal involvement, age-adjusted international prognostic index (aaIPI), rituximab infusion and radiotherapy on patient outcomes were evaluated.

RESULTS

Among these patients, 59% presented extranodal involvement in 16 anatomic sites. More than one instance was linked to many poorer clinical characteristics and poorer survival compared with either nodal disease or one instance. In patients with one extranodal lesion, multivariate analysis revealed that the site of extranodal involvement, but not the aaIPI or rituximab infusion, was independently related to the outcome, and radiotherapy had a negative influence on survival.

CONCLUSIONS

Extranodal involvement is common in younger patients and exhibits a ubiquitous distribution. The site of extranodal involvement is of strong prognostic significance. Radiotherapy for extranodal lesions does not improve patient outcomes.

摘要

目的

结外受累是弥漫性大B细胞淋巴瘤（DLBCL）的一种特殊表现形式。既往研究提示老年患者更易出现结外受累。本研究回顾性探讨了年轻DLBCL患者结外受累的分布情况、预后价值及治疗选择。

方法

根据纳入标准共纳入329例患者。评估性别、结外受累情况、年龄校正国际预后指数（aaIPI）、利妥昔单抗输注及放疗对患者预后的影响。

结果

在这些患者中，59%在16个解剖部位出现结外受累。与仅累及淋巴结或仅有一处结外受累相比，多处结外受累与许多更差的临床特征及更差的生存率相关。在仅有一处结外病变的患者中，多因素分析显示结外受累部位而非aaIPI或利妥昔单抗输注与预后独立相关，且放疗对生存有负面影响。

结论

结外受累在年轻患者中常见且分布广泛。结外受累部位具有很强的预后意义。结外病变放疗并不能改善患者预后。