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目的比较以坏死为主的鼻腔恶性淋巴瘤（原诊断为坏死性肉芽肿）和以新生物为主的鼻腔淋巴瘤临床预后的差异。方法１９９１年３月～１９９６年６月我院收治的免疫组化证实的鼻腔恶性淋巴瘤７６例，其中３５例临床表现以坏死、溃疡或伴恶臭为主，免疫组化检测均为Ｔ细胞淋巴瘤。ＡｎｎＡｒｂｏｒ分期Ⅰ，Ⅱ期。采用局部放射治疗和（或）全身化疗。数据用Ｋａｐｌａｎ－Ｍｅｉｅｒ法分析，Ｌｏｇ－ｒａｎｋ检验。结果以坏死为主的鼻腔恶性淋巴瘤和以新生物为主的鼻腔恶性淋巴瘤５年生存率分别为４３％和４９％（Ｐ＝０．５９）。５年无瘤生存率分别为３９％和４２％（Ｐ＝０．８１）。５年局控率分别为８９％和９５％（Ｐ＝０．２８）。５年远处侵犯率分别为２０％和２６％（Ｐ＝０．０９）。结论以坏死为主的鼻腔恶性淋巴瘤和以新生物为主的鼻腔恶性淋巴瘤，两者临床预后差异无显著意义，为同一组疾病两种不同的表型。
Objective To compare the differences in the clinical prognosis of neoplasm-predominant nasal lymphoma (previously diagnosed as necrotic granuloma) versus neoplasm-based nasal lymphoma. Methods From March 1991 to June 1996, 76 cases of nasal malignant lymphoma confirmed by immunohistochemistry were treated in our hospital. The clinical manifestations of 35 cases were necrosis, ulcer or malodor, and the immunohistochemistry was T cell lymph tumor. AnnArbor stage Ⅰ, Ⅱ. Using local radiotherapy and / or systemic chemotherapy. Data were analyzed by Kaplan-Meier method, Log-rank test. Results The 5-year survival rates of nasal malignant lymphoma and neoplasm-predominant nasal malignant lymphoma with necrosis were 43% and 49%, respectively (P = 0.59). The 5-year disease-free survival rates were 39% and 42%, respectively (P = 0.81). The 5-year local control rates were 89% and 95%, respectively (P = 0.28). The rates of abduction at 5 years were 20% and 26% respectively (P = 0.09). Conclusions There is no significant difference between the two groups in the prognosis of nasal malignant lymphoma, which is predominantly necrosis, and neoplasm of nasal malignant lymphoma, which are two different phenotypes of the same group of diseases.