Sun R, Shi Q, Shen R, Qian Y, Xu P P, Chen S, Wang L, Zhao W L
Shanghai Institute of Hematology, Shanghai Rui Jin Hospital, State Key Laboratory of Medical Genomics, Shanghai 200025, China.
Zhonghua Xue Ye Xue Za Zhi. 2019 Jul 14;40(7):568-572. doi: 10.3760/cma.j.issn.0253-2727.2019.07.006.
To compare clinical characteristics and prognosis between patients with primary (PTL) and secondary thyroid lymphoma (STL) . A retrospective analysis was performed on 46 patients with thyroid lymphoma (PTL 19, STL 27) from January 2002 to October 2018. ①PTL group included 4 males and 15 females, with a median age of 57 years. The STL group included 10 males and 17 females, with a median age of 61 years. Diffuse large B-cell lymphoma (DLBCL) was the main pathological subtype in both PTL and STL groups, with 14 cases (73.7%) and 20 cases (74.1%) respectively. In terms of clinical manifestations, goiter was the most common symptom in PTL patients 100.0% (19/19) , while 29.6% (8/27) STL had goiter (<0.001) . The incidences of increased thyroglobulin antibody (TRAb) /thyroid peroxidase antibody (TPO) were 81.3% (13/16) in PTL group and 43.8% (7/16) in STL group (=0.028) respectively. Concerning the clinical features of patients, only two PTL patients (10.5%) with advanced Ann Arbor stage (Ⅲ/Ⅳ) , while 21 (77.8%) STL experienced advanced Ann Arbor stage (<0.001) . Elevated serum β(2)-MG were appeared in 1 (7.1%) PTL and 9 (47.4%) STL patients (=0.013) , and advanced IPI score (3-5) was more common in STL than PTL (59.3% 5.3%, <0.001) . ②Among the 17 PTL patients who received treatments, 15 (88.2%) achieved remission; as for STL patients received treatments, 23/25 (92.0%) were in remission. The 5-year overall survival (OS) rates of PTL (=17) and STL groups (=25) were (87.4±8.4) % and (70.0±13.1) % (=0.433) respectively. ③The 5-year OS rate in 41 patients with B-cell thyroid lymphoma was (81.1±7.5) %. Univariate analysis showed that IPI score of 3-5 (=0.040) and high level of serum IL-8 (=0.022) were significantly associated with poor outcome. DLBCL was the most common subtype in both PTL and STL, and goiter was the major symptom in PTL. IPI score of 3-5 and high level of serum IL-8 were unfavorable prognostic factors for patients with B-cell thyroid lymphoma.
比较原发性甲状腺淋巴瘤（PTL）和继发性甲状腺淋巴瘤（STL）患者的临床特征及预后。对2002年1月至2018年10月期间46例甲状腺淋巴瘤患者（PTL 19例，STL 27例）进行回顾性分析。①PTL组包括4例男性和15例女性，中位年龄57岁。STL组包括10例男性和17例女性，中位年龄61岁。弥漫性大B细胞淋巴瘤（DLBCL）是PTL和STL组的主要病理亚型，分别有14例（73.7%）和20例（74.1%）。在临床表现方面，甲状腺肿大是PTL患者最常见的症状，占100.0%（19/19），而STL患者中29.6%（8/27）有甲状腺肿大（<0.001）。PTL组甲状腺球蛋白抗体（TRAb）/甲状腺过氧化物酶抗体（TPO）升高的发生率分别为81.3%（13/16），STL组为43.8%（7/16）（P = 0.028）。关于患者的临床特征，只有2例PTL患者（10.5%）处于晚期Ann Arbor分期（Ⅲ/Ⅳ期），而21例（77.8%）STL患者处于晚期Ann Arbor分期（<0.001）。1例（7.1%）PTL患者和9例（47.4%）STL患者血清β2微球蛋白升高（P = 0.013），晚期国际预后指数（IPI）评分（3 - 5分）在STL中比PTL更常见（59.3%对5.3%，<0.001）。②在接受治疗的17例PTL患者中，15例（88.2%）达到缓解；接受治疗的STL患者中，23/25例（92.0%）缓解。PTL组（n = 17）和STL组（n = 25）的5年总生存率分别为（87.4±8.4）%和（70.0±13.1）%（P = 0.433）。③41例B细胞甲状腺淋巴瘤患者的5年总生存率为（81.1±7.5）%。单因素分析显示，IPI评分为3 - 5分（P = 0.040）和血清IL - 8水平高（P = 0.022）与不良预后显著相关。DLBCL是PTL和STL中最常见的亚型，甲状腺肿大是PTL的主要症状。IPI评分为3 - 5分和血清IL - 8水平高是B细胞甲状腺淋巴瘤患者的不良预后因素。
