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分析鼻腔原发非霍奇金氏淋巴瘤(non Hodgkin’slymphoma,NHL)的临床特征和影响预后的因素。方法 :回顾性研究1982年至1999年本院38例原发于鼻腔及鼻窦的NHL的临床特点、诊断及治疗。结果 :38例患者按照AnArbor分期 ,Ⅰ期14例 ,Ⅱ期11例 ,Ⅲ期7例 ,Ⅳ期6例 ,就诊主要症状为鼻塞、流涕和鼻衄等 ,11例 (29 % )伴有发热、盗汗或体重下降等全身症状。38例患者淋巴瘤细胞为小细胞至大细胞性等多种类型 ,病变内常见坏死改变 ,25例进行免疫表型分析 ,全部为T细胞性。除6例早期患者单独放疗、7例化疗外 ,其余25例采用放化疗综合治疗。全组预期5年生存率65 % ,早期局限病变 (Ⅰ、Ⅱ期组 )79 45 % ,晚期病变 (Ⅲ、Ⅳ期组 )为0 ,两组生存率差别显著(χ2=15 57,P<0 001)。结论 :临床分期为鼻腔原发NHL的主要预后因素 ,早期局限病变疗效较好 ;晚期病变发展迅速 ,常规治疗预后差 ,应探索更为有效的治疗策略
Analyze the clinical characteristics and prognostic factors of primary nasal non-Hodgkin’s lymphoma (NHL). Methods :Retrospectively studied the clinical features, diagnosis and treatment of 38 cases of NHL originating from nasal cavity and paranasal sinuses from 1982 to 1999. Results: According to An Arbor, 38 patients were staged according to An Arbor, with 14 cases in phase I, 11 in stage II, 7 in stage III, and 6 in stage IV. The main symptoms were nasal congestion, runny nose and epistaxis. 11 cases (29%) were associated with Systemic symptoms such as fever, night sweats, or weight loss. 38 cases of patients with lymphoma cells from small cells to large cell types and other types of changes in necrosis within the lesion, 25 cases of immunophenotypic analysis, all T cells. In addition to 6 cases of early radiotherapy alone, 7 cases of chemotherapy, the remaining 25 cases using radiotherapy and chemotherapy comprehensive treatment. The overall 5-year survival rate was expected to be 65%, with early localized lesions (stages I and II) being 79.5% and late stage lesions (stages III and IV) being 0. The difference in survival rates between the two groups was significant (χ2=1557, P< 0 001). Conclusion: Clinical staging is the main prognostic factor for primary NHL in the nasal cavity. The curative effect of early localized lesions is better. The late lesions develop rapidly and the prognosis of routine treatment is poor. More effective treatment strategies should be explored.