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目的:回顾性总结及分析肾上腺淋巴瘤患者的临床特点及预后。方法:收集本中心2002-01-2013-12收治的肾上腺淋巴瘤患者共18例,其中包括原发性肾上腺淋巴瘤(PAL)10例,继发性肾上腺淋巴瘤(SAL)8例。随访终点时间为2014年3月30日。生存分析采用Kaplan-Meier方法,Log-rank方法进行组间比较。结果:在病理亚型上,无论是PAL还是SAL,均以弥漫大B细胞淋巴瘤最多见,其次为外周T细胞淋巴瘤非特指型。在临床表现上,2组患者最常见的症状类似,均为B症状、乏力、腰背部局部不适感、纳差等。SAL患者肝脾肿大和Ann Arbor分期Ⅲ/Ⅳ期较多见(P=0.019和P=0.036)。无论是PAL还是SAL,患者的总生存时间差异无统计学意义。IPI评分≥3分或T细胞来源的淋巴瘤,患者生存时间显著缩短(P=0.049 5,P=0.003 4)。结论:肾上腺淋巴瘤缺乏特异的临床表现,以弥漫大B细胞淋巴瘤最多见。IPI≥3分或T细胞来源,患者的生存时间显著缩短。由于本研究的病例数较少,仍需要大规模的前瞻性研究来验证。
Objective: To retrospectively summarize and analyze the clinical features and prognosis of patients with adrenal lymphoma. METHODS: A total of 18 patients with adrenal lymphoma who were admitted to our center from January 2002 to December 2013 were enrolled, including 10 cases of primary adrenal lymphoma (PAL) and 8 cases of secondary adrenal lymphoma (SAL). End of follow-up is March 30, 2014. Survival analysis Kaplan-Meier method, Log-rank method for comparison between groups. Results: In pathological subtypes, both PAL and SAL were the most common diffuse large B cell lymphoma, followed by nonspecific peripheral T cell lymphoma. In clinical manifestations, the two groups of patients with the most common symptoms are similar, symptoms are B, fatigue, partial discomfort of the lower back, anorexia and so on. Patients with salivary splenomegaly and Ann Arbor stage III / IV were more common in SAL patients (P = 0.019 and P = 0.036). No difference was found in the overall survival of patients, no matter PAL or SAL. Patients with IPI score ≥3 or T-cell lymphoma had significantly shorter survival time (P = 0.049 5, P = 0.003 4). Conclusion: Adrenal lymphoma lacks specific clinical manifestations and is most commonly seen in diffuse large B-cell lymphoma. IPI ≥ 3 points or T cell sources, the patient's survival time was significantly shorter. Due to the small number of cases in this study, large-scale prospective studies are still needed to verify.