Yokohama Akihiko, Hashimoto Yoko, Takizawa Makiko, Shimizu Hiroaki, Miyazawa Yuri, Saitoh Akio, Toyama Kohtaro, Ishizaki Takuma, Mitsui Takeki, Saitoh Takayuki, Murayama Kayoko, Matsumoto Morio, Sawamura Morio, Murakami Hirokazu, Hirato Junko, Kojima Masaru, Nojima Yoshihisa, Handa Hiroshi, Tsukamoto Norifumi
Blood Transfusion Service, Gunma University Hospital, Faculty of Medicine, Gunma University, Maebashi, Gunma, Japan.
Department of Hematology, Gunma University Graduate School of Medicine.
J Clin Exp Hematop. 2018 Mar 16;58(1):10-16. doi: 10.3960/jslrt.17031. Epub 2018 Feb 8.
Recent studies have revealed the clinical and biological features of stage I follicular lymphoma (FL), but information about patients with stage I FL who underwent total resection after tissue biopsy is limited. Among 305 FL patients diagnosed between 2001 and 2013, clinical stage I disease was observed in 36 patients. Of these, 18 patients underwent total resection after diagnostic tissue biopsy. We used F-fluorodeoxyglucose positron emission CT for staging assessment in 13 of 18 patients (72.2%). The median age was 56.5 years. Six patients (33.3%) were male. The soluble interleukin-2 receptor alpha concentration was significantly lower than in patients with residual disease. Among these 18 patients, 7 patients (38.9%) were treated with a "watch-and-wait" (WW) policy, 7 (38.9%) were treated with involved-field irradiation, and 4 (22.2%) received systemic chemotherapy. Patients with resected disease were treated with significantly different strategies from those with residual disease (p = 0.0026). Five patients experienced relapse during follow-up (median follow-up: 48.2 months). All relapses were distant from the primary site, irrespective of treatment strategy. Among all stage I patients, disease resection was not a significant factor for survival (p = 0.9294). Collectively, the choice of treatment strategy was significantly influenced by patient status. Resection status was not significantly associated with survival after several treatment strategies.
近期研究揭示了Ⅰ期滤泡性淋巴瘤（FL）的临床和生物学特征，但关于组织活检后接受根治性切除的Ⅰ期FL患者的信息有限。在2001年至2013年间确诊的305例FL患者中，36例为临床Ⅰ期疾病。其中，18例患者在诊断性组织活检后接受了根治性切除。我们对18例患者中的13例（72.2%）使用F-氟脱氧葡萄糖正电子发射计算机断层显像进行分期评估。中位年龄为56.5岁。6例患者（33.3%）为男性。可溶性白细胞介素-2受体α浓度显著低于有残留病灶的患者。在这18例患者中，7例（38.9%）采用“观察等待”（WW）策略治疗，7例（38.9%）接受累及野照射，4例（22.2%）接受全身化疗。接受手术切除疾病的患者与有残留疾病的患者治疗策略显著不同（p = 0.0026）。5例患者在随访期间复发（中位随访时间：48.2个月）。所有复发均远离原发部位，与治疗策略无关。在所有Ⅰ期患者中，疾病切除不是生存的显著因素（p = 0.9294）。总体而言，治疗策略的选择受患者状态的显著影响。在几种治疗策略后，切除状态与生存无显著相关性。
