Su Q, Peng X, Zhou C X, Yu G Y
Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomato-logy & NHC Research Center of Engineering and Technology for Computerized Dentistry & NMPA Key Laboratory for Dental Materials, Beijing 100081, China.
Department of Oral Pathology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomato-logy & NHC Research Center of Engineering and Technology for Computerized Dentistry & NMPA Key Laboratory for Dental Materials, Beijing 100081, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2023 Feb 18;55(1):13-21. doi: 10.19723/j.issn.1671-167X.2023.01.003.
To investigate the clinicopathological characteristics and factors influencing the prognosis of non-Hodgkin lymphoma (NHL) in oral and maxillofacial regions.
Clinicopathological data of 369 patients with oral and maxillofacial NHL initially diagnosed in Peking University Hospital of Stomatology from 2008 to 2020 were collected and analyzed retrospectively.
There were 180 males and 189 females. The median age of the patients was 56 years (3 months to 92 years), and the median duration was three months. Clinically, 283 cases manifested as mass, 38 cases as ulcerative necrotizing lesions, and 48 cases as diffuse soft tissue swelling. The lesions of 90 cases located in face and neck (75 cases neck, 20.3%), 99 cases were of major salivary glands (79 cases parotid glands, 20.9%), 103 cases of oral cavity, 50 cases of maxillofacial bones, 20 cases of Waldeyer's ring, and 7 cases of infratemporal fossa. In the study, 247 of the 369 patients had cervical lymphadenopathy, only 40 cases had B symptoms, and 23 cases had the bulky disease. Of the 369 NHLs, 299 (81%) were B-cell NHL, and 70(19%) were T-cell NHL. Diffuse large B-cell lymphoma, extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue, follicular lymphoma, and extranodal natural killer (NK)/T-cell lymphoma nasal type were the most common pathological subtypes. According to Ann Arbor staging, 87, 138, 106, and 38 cases were classified as staged Ⅰ, Ⅱ, Ⅲ, Ⅳ, respectively. The me-dian follow-up time was 48 months, 164 patients died during the follow-up period. The overall survival rates for one year, two years, and five years were 90.1%, 82.4%, and 59.9%, respectively, and the median survival was (86.00±7.98) months. Multivariate analysis showed that age ( < 0.001), Ann Arbor staging ( < 0.001), elevated lactate dehydrogenase (=0.014), and pathological subtype (=0.049) were the independent factors influencing the overall survival rate of NHL patients.
Oral and maxillofacial NHL has unique clinical characteristics and distribution patterns of pathological subtypes. Fewer patients had systemic symptoms. Neck and parotid glands were the most common sites invaded by NHL. Advanced age, Ann Arbor stage Ⅲ-Ⅳ, B symptoms, and T-cell NHL may predict a poor prognosis in oral and maxillofacial NHL patients.
探讨口腔颌面部非霍奇金淋巴瘤（NHL）的临床病理特征及影响预后的因素。
回顾性收集并分析2008年至2020年在北京大学口腔医院初诊的369例口腔颌面部NHL患者的临床病理资料。
男性180例，女性189例。患者中位年龄56岁（3个月至92岁），中位病程3个月。临床上，283例表现为肿块，38例为溃疡性坏死性病变，48例为弥漫性软组织肿胀。90例病变位于面颈部（颈部75例，占20.3%），99例位于大唾液腺（腮腺79例，占20.9%），103例位于口腔，50例位于颌面部骨，20例位于咽淋巴环，7例位于颞下窝。本研究中，369例患者中有247例有颈部淋巴结肿大，仅40例有B症状，23例有大包块病变。369例NHL中，299例（81%）为B细胞NHL，70例（19%）为T细胞NHL。弥漫性大B细胞淋巴瘤、黏膜相关淋巴组织结外边缘区B细胞淋巴瘤、滤泡性淋巴瘤和结外鼻型自然杀伤（NK）/T细胞淋巴瘤是最常见的病理亚型。根据Ann Arbor分期，Ⅰ、Ⅱ、Ⅲ、Ⅳ期分别为87例、138例、106例和38例。中位随访时间为48个月，随访期间164例患者死亡。1年、2年和5年总生存率分别为90.1%、82.4%和59.9%，中位生存期为（86.00±7.98）个月。多因素分析显示，年龄（<0.001）、Ann Arbor分期（<0.001）、乳酸脱氢酶升高（=0.014）和病理亚型（=0.049）是影响NHL患者总生存率的独立因素。
口腔颌面部NHL具有独特的临床特征和病理亚型分布模式。有全身症状的患者较少。颈部和腮腺是NHL最常侵犯的部位。高龄、Ann Arbor分期Ⅲ - Ⅳ期、B症状和T细胞NHL可能预示口腔颌面部NHL患者预后不良。
