Hahn J S, Lee S, Chong S Y, Min Y H, Ko Y W
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Yonsei Med J. 1997 Oct;38(5):270-84. doi: 10.3349/ymj.1997.38.5.270.
Several reports have suggested a geographic difference in the histopathologic characteristics and prognosis of malignant lymphoma around the world. We tried to evaluate the clinical and histopathologic characteristics, therapeutic outcomes, and prognostic features of malignant lymphoma, particularly in Korean patients. Three hundred and seventy-six adult patients with the initial histopathologic diagnosis of malignant lymphoma of Yonsei University College of Medicine over an 8-year period were analyzed, retrospectively, with the following results: 1) There were 47 cases of Hodgkin's disease (HD) (12.5%) and 329 of non-Hodgkin's lymphoma (NHL) (87.5%) with a 1:7 ratio. The most common histopathologic subtype of HD was mixed cellularity (44.7%), and that of NHL was intermediate grade (70.8%), especially diffuse large-cell type (44.1%), whereas follicular type was less common. In regard to the incidence of extranodal presentation, it is rare in HD (4.2%), but occurs in 49.8% of patients with NHL. 2) The complete remission (CR) rate was 91.5% in HD and 63.6% in NHL, and the 5-year and 7-year disease-free survival rates were 71.3% and 57.0% in HD; 67.0% and 49.6% in NHL. The 5-year and 8-year overall survival rates were 90.7% and 68.0% in HD; 65.2% and 60.2% in NHL. 3) By multivariate analysis, we found that age, performance status, histopathologic grade, stage, serum lactate dehydrogenase (LDH) and beta 2-microglobulin were the useful prognostic factors in predicting survival in NHL, while no definite prognostic factors were found in HD. Also, in NHL patients less than 60 years old, stage, serum LDH, and histopathologic grade were closely associated with their therapeutic outcomes. In conclusion, the characteristics of malignant lymphoma in our hospital differ from those in Western countries with respect to the clinical, histopathologic and immunophenotypic patterns, but the prognostic factors and overall therapeutic outcomes were quite comparable to those of other reports from Western countries.
几份报告表明，世界各地恶性淋巴瘤的组织病理学特征和预后存在地域差异。我们试图评估恶性淋巴瘤的临床和组织病理学特征、治疗效果及预后特征，尤其是韩国患者的情况。对延世大学医学院8年间初诊为恶性淋巴瘤的376例成年患者进行回顾性分析，结果如下：1）有47例霍奇金病（HD）（12.5%）和329例非霍奇金淋巴瘤（NHL）（87.5%），比例为1:7。HD最常见的组织病理学亚型是混合细胞型（44.7%），NHL最常见的是中级（70.8%），尤其是弥漫大细胞型（44.1%），而滤泡型较少见。关于结外表现的发生率，HD中少见（4.2%），但NHL患者中有49.8%出现。2）HD的完全缓解（CR）率为91.5%，NHL为63.6%；HD的5年和7年无病生存率分别为71.3%和57.0%；NHL为67.0%和49.6%。HD的5年和8年总生存率分别为90.7%和68.0%；NHL为65.2%和60.2%。3）多因素分析发现，年龄、体能状态、组织病理学分级、分期、血清乳酸脱氢酶（LDH）和β2微球蛋白是预测NHL生存的有用预后因素，而HD中未发现明确的预后因素。此外，在年龄小于60岁的NHL患者中，分期、血清LDH和组织病理学分级与治疗效果密切相关。总之，我院恶性淋巴瘤在临床、组织病理学和免疫表型模式方面与西方国家不同，但预后因素和总体治疗效果与西方国家的其他报告相当。
