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目的 评价原发扁桃体非霍奇金淋巴瘤 (NHL)的肿瘤侵犯范围 (T分期 )和国际预后指数 (IPI)的预后价值 ,并对早期患者提出治疗建议。方法 回顾分析 30 6例原发扁桃体NHL。根据AnnArbor分期 ,Ⅰ期 35例 ,Ⅱ期 178例 ,Ⅲ期 4 9例 ,Ⅳ期 4 4例。根据 1997年AJCCTNM分期标准 ,T12 9例 ,T2 14 2例 ,T3117例 ,T4 18例。Ⅰ期单纯放射治疗 12例 ,综合治疗 2 3例 ;Ⅱ期单纯放射治疗 5 7例 ,单纯化疗 2例 ,综合治疗 119例 ;Ⅲ、Ⅳ期以化疗为主。结果 T1、T2、T3和T4的 5年癌症相关生存率 (CSS)分别为 73.8%、5 9.0 %、5 6 .5 %和 2 6 .5 % (P <0 .0 5 ) ;IPI评分 0分、1分和 2或 3分的 5年CSS分别为 6 9.9%、4 9.0 %和 2 5 .0 % (P <0 .0 1)。Ⅱ期单纯放疗和综合治疗的 5年无瘤生存率 (DFS)分别为 4 6 .2 %和 6 0 .4 % (P <0 .0 5 )。多因素分析证明 ,影响预后的因素有一般状态、B症状、AnnArbor分期、T分期和IPI。结论 原发肿瘤T分期和IPI是扁桃体NHL重要的预后因素。综合治疗改善了Ⅱ期扁桃体NHL的DFS。
Objective To evaluate the prognostic value of tumor invasion (T stage) and International Prognostic Index (IPI) in patients with primary tonsillial non-Hodgkin’s lymphoma (NHL) and to provide recommendations for the treatment of early-stage patients. Methods A retrospective analysis of 30 6 cases of primary tonsil NHL. According to AnnArbor stage, 35 cases were stage Ⅰ, 178 cases were stage Ⅱ, 49 cases were stage Ⅲ, and 44 cases were stage Ⅳ. According to 1997 AJCCTNM staging criteria, T12 9 cases, T2 14 2 cases, T3117 cases, T4 18 cases. 12 cases of stage Ⅰ radiotherapy alone, 23 cases of comprehensive treatment; Ⅱ radiotherapy alone 57 cases, chemotherapy alone in 2 cases, 119 cases of comprehensive treatment; Ⅲ, Ⅳ chemotherapy based. Results The 5-year cancer-related survival rates (CSS) of T1, T2, T3 and T4 were 73.8%, 59.0%, 56.5% and 26.5% respectively (P <0.05) The 5-year CSS scores of 1, 2 and 3 were 6 9.9%, 9.0% and 25.0%, respectively (P <0.01). The 5-year disease-free survival (DFS) of stage II radiotherapy alone and combined treatment were 46.2% and 60.4%, respectively (P <0.05). Multivariate analysis showed that the prognostic factors include general status, B symptoms, Ann Arbor staging, T staging and IPI. Conclusion T stage and IPI of primary tumor are important prognostic factors of tonsil NHL. The combination treatment improves the DFS of stage II tonsil NHL.