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37例原发性甲状腺淋巴瘤的临床病理特征及治疗结果

[Clinicopathological features and treatment outcome of 37 cases of primary thyroid lymphoma].

作者信息

Zhou Y, Xu X, Xu H, Cui G H, Zhang L

机构信息

Department of Otolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.

Department of Pathology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology.

出版信息

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2018 Oct;32(20):1551-1556. doi: 10.13201/j.issn.1001-1781.2018.20.005.

DOI:10.13201/j.issn.1001-1781.2018.20.005
PMID:30400705
Abstract

The aim of this study is to explore the clinicopathological features and treatment outcome of primary thyroid lymphoma(PTL). Clinicopathological data of 37 cases of PTL were retrospectively reviewed, and analyzed in combined with followup data. Of the 37 patients, Hashimoto's disease was diagnosed in 28(75.7%) patients. The diagnostic rate of preoperative fine needle biopsy (75%) was higher than the fine needle aspiration (53%). The pathological types of these patients included diffuse large B cell lymphoma(=23), extranodal marginal zone lymphoma of mucosaassociated lymphoid tissue type (MALT) (=10), follicular lymphoma(FL) grade 3 (=3) and burkitt lymphoma(BL) (=1). According to Ann Arbor staging system, 12 patients with stage ⅠE, and 25 patients with stage ⅡE. With a median followup period of 37 months (2-93 months), the 3year overall survival (OS) rate and progression free survival(PFS) was 87.0% and 81.6%, and 5year overall survival(OS) rate and PFS was 79.8% and 74.8%. Univariate survival analysis found that comprehensive treatment was an important factor affecting prognosis, but there was no statistical difference in the effects of age, gender, lactate dehydrogenase, level, β2 microglobulin, Ann Arbor staging, international prognostic index, and tissue subtype on survival (>0.05). PTL mostly affects middle aged and old female and has a favorable prognosis. Core needle biopsy can improve the diagnostic rate when compared with fine needle aspiration. The optimal treatment is combined modality strategy based on chemotherapy and radiotherapy, and supplemented by surgery.

摘要

本研究旨在探讨原发性甲状腺淋巴瘤(PTL)的临床病理特征及治疗效果。回顾性分析37例PTL患者的临床病理资料,并结合随访数据进行分析。37例患者中,28例(75.7%)诊断为桥本氏病。术前粗针穿刺活检诊断率(75%)高于细针穿刺抽吸(53%)。这些患者的病理类型包括弥漫性大B细胞淋巴瘤(=23)、黏膜相关淋巴组织型(MALT)结外边缘区淋巴瘤(=10)、3级滤泡性淋巴瘤(FL)(=3)和伯基特淋巴瘤(BL)(=1)。根据Ann Arbor分期系统,ⅠE期12例,ⅡE期25例。中位随访时间为37个月(2 - 93个月),3年总生存率(OS)和无进展生存率(PFS)分别为87.0%和81.6%,5年总生存率(OS)和PFS分别为79.8%和74.8%。单因素生存分析发现综合治疗是影响预后的重要因素,但年龄、性别、乳酸脱氢酶水平、β2微球蛋白、Ann Arbor分期、国际预后指数及组织亚型对生存的影响无统计学差异(>0.05)。PTL多影响中老年女性,预后良好。与细针穿刺抽吸相比,粗针活检可提高诊断率。最佳治疗方案是以化疗和放疗为基础,辅以手术的综合治疗策略。

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