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目的分析原发性甲状腺淋巴瘤的临床表现、诊断、治疗及预后。方法回顾1995至2005年间我院收治的原发性甲状腺淋巴瘤30例,分析其临床表现、病理分型、临床分期、治疗方案及预后。结果原发性甲状腺淋巴瘤总的2及5年生存率分别为86.7%和73.7%。手术治疗组、手术+放疗组、手术+化疗组、手术+放疗+化疗组5年生存率分别为66.7%、100%、77.8%和71.4%,组间无统计学差异。低度恶性/惰性淋巴瘤组2、5年生存率分别为92.9%和92.9%,高于中高度恶性/侵袭性淋巴瘤组的71.4%和47.6%,二者间差异有非常显著性(P<0.01)。Ⅰ期患者2、5年生存率分别为90.9%和90.9%,高于Ⅱ期的75.0%和58.3%,二者间差异有显著性(P<0.05)。本组的甲状腺淋巴瘤生存率在年龄、性别、血清乳酸脱氢酶(LDH)、血清β2-微球蛋白(β2-MG)、手术方式、气管切开组间差异无显著性。结论甲状腺淋巴瘤的预后与病理分型、临床分期及治疗方案密切相关。治疗以手术+放疗+化疗综合治疗为主,但应根据患者的具体情况(年龄、病理类型、临床分期、肿瘤大小、全身情况等)选择治疗方式。
Objective To analyze the clinical manifestations, diagnosis, treatment and prognosis of primary thyroid lymphoma. Methods Thirty cases of primary thyroid lymphoma treated in our hospital from 1995 to 2005 were retrospectively analyzed. The clinical manifestations, pathological types, clinical stages, treatment regimens and prognosis were analyzed. Results The overall 2-year and 5-year survival rates of primary thyroid lymphoma were 86.7% and 73.7%, respectively. The 5-year survival rate was 66.7%, 100%, 77.8% and 71.4% in operation group, operation + radiotherapy group, operation + chemotherapy group and operation + radiotherapy + chemotherapy group respectively. There was no significant difference between the two groups. The 2-and 5-year survival rates were 92.9% and 92.9% in low-grade / non-malignant lymphoma group, respectively, which were significantly higher than 71.4% and 47.6% in medium- and high-grade malignant / aggressive lymphoma group, respectively <0.01). The 2-year and 5-year survival rates of stage Ⅰ patients were 90.9% and 90.9%, respectively, which were higher than 75.0% and 58.3% of stage Ⅱ patients (P <0.05). This group of thyroid lymphoma survival rate in age, gender, serum lactate dehydrogenase (LDH), serum β2-microglobulin (β2-MG), surgical methods, tracheotomy group no significant difference between groups. Conclusion The prognosis of thyroid lymphoma is closely related to the pathological type, clinical stage and treatment plan. Treatment with surgery + radiotherapy + chemotherapy combined therapy, but should be based on the specific circumstances of patients (age, pathological type, clinical stage, tumor size, general condition, etc.) to choose the treatment.