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目的:探讨眼附属器MALT淋巴瘤的诊断、治疗、疗效及预后影响因素。方法:回顾性分析1997年1月至2008年1月68例病理确诊的ⅠE期眼附属器MALT淋巴瘤患者的临床表现、影像学结果、治疗经过、放疗疗效及预后情况。结果:本研究68例ⅠE期眼附属器MALT淋巴瘤中男性44例,女性24例,男女比例1.83:1。原发于眼眶40例,眼睑5例,泪腺11例,结膜12例。经过55月(28-135月)的随访,5年总生存率为91.3%,5年的局部控制率为97%。结论:眼附属器MALT淋巴瘤好发于老年男性,以侵及眼眶者居多,B超、CT、MRI仅可提供较好的定性、定位诊断,确诊仍需病理诊断。手术切除联合局部放射治疗对ⅠE期眼附属器MALT淋巴瘤有较好的疗效。眼附属器MALT淋巴瘤有转化为弥漫性大B细胞淋巴瘤的潜在危险,放射治疗后长期的随访仍然是必须的。放疗或化疗也可以作为成功的补救措施。
Objective: To investigate the diagnosis, treatment, efficacy and prognostic factors of ocular adnexal MALT lymphoma. Methods: The clinical manifestations, imaging findings, treatment outcome, radiotherapy and prognosis were retrospectively analyzed in 68 patients with pathologically confirmed stage IE MALT lymphoma from January 1997 to January 2008. Results: There were 44 males and 24 females in 68 cases of stage IE MALT lymphoma, the ratio of male to female was 1.83: 1. 40 cases of primary orbital, eyelid in 5 cases, 11 cases of lacrimal gland, conjunctiva in 12 cases. After 55 months (28-135 months) follow-up, 5-year overall survival was 91.3%, 5-year local control rate of 97%. Conclusion: The appendage MALT lymphoma occurs predominantly in elderly men. Most of the patients are infiltrating the orbit. B-ultrasound, CT and MRI can only provide good qualitative and positional diagnosis. The pathological diagnosis is still required. Surgical resection combined with local radiotherapy for Ⅰ E period ocular adnexal MALT lymphoma has a good effect. The ocular adnexal MALT lymphoma has the potential to convert to diffuse large B-cell lymphoma, and long-term follow-up after radiotherapy is still necessary. Radiotherapy or chemotherapy can also be used as a successful remedy.