原发性乳腺淋巴瘤25例临床剖析.docVIP

原发性乳腺淋巴瘤25例临床剖析 　　[摘要] 目的 分析原发性乳腺淋巴瘤（primary breast lymphoma，PBL）的临床特点及预后，以提高对本病的认识。方法收集并回顾性分析中山市博爱医院2001年1月～2012年12月收治的原发性乳腺淋巴瘤临床资料和治疗情况。结果 病理均是B 细胞性来源（25/25），弥漫大B 细胞型占61.5%（16/25）。本组患者总的5年生存率分别为44%，含有手术治疗模式较无手术治疗模式的5年生存时间、5年局部控制率、5年无远处转移率无显著差异（P0.05）；含有放疗模式治疗较无放疗治疗模式的5年生存时间、5年无远处转移率无显著差异（P0.05），但是5年局部控制率比较，差异有统计学意义（P0.05），但5年无远处转移率比较，差异有统计学意义（P0.05）。 结论 肿瘤分期及病理类型与PBL预后相关，局部放疗有助于提高局部控制率，化疗有助于提高远处转移控制率，手术联合放、化疗是较合理的治疗方案。 　　[关键词] 原发性乳腺淋巴瘤；临床特点；预后 　　[中图分类号] R737.9 [文献标识码] B [文章编号] 1673-9701（2014）23-0141-04 　　[Abstract] Objective To improve the recognition and management of primary breast lymphoma（PBL） by discussing the clinical pathological characteristics and the prognosis of PBL. Methods The clinical and treatment records of PBL patients admitted in Boai hospital of zhongshan from January 2001 to December 2012 were analyzed. Results All cases were B-cell origin（25/25）， 61.5 %（16/25）were diffuse large B-cell lymphoma origin， The 5-year overall survival was 44%. There were no significant difference in the 5-year overall survival rates， 5-year local control rates and 5-year distant control rates in patient treatment with any surgery compared with no-Surgery（P0.05）.There were no significant difference in the 5-year overall survival rates and 5-year distant control rates in patient treatment with any RT compared with no-RT（P0.05），but the 5-year local control rates was significantly different（P0.05）. but the 5-year distant control rates was significant different（P0.05）. Conclusion The prognosis of PBL is related with the clinical stage and pathological type. Radiotherapy and chemotherapy respectively promote the local control and distant control. The optimal treatment is surgery combined with chemotherapy and/or radiotherapy. 　　[Key words] Primary breast lymphoma；Clinical features；Prognosis 　　结外淋巴瘤约占非何杰金淋巴瘤的1/4，原发乳腺淋巴瘤约占乳腺恶性肿瘤的0.004%～1%，非何杰金淋巴瘤不超过1%[1]。许多研究表明，原发乳腺淋巴瘤与乳腺癌临床表现及影像学表现相似，无痛性肿块、淋巴结侵犯，但是两者的治疗是截然不同的。本文旨在回顾性分析我院2001年1月～2012年12月收治的原发性乳腺淋巴瘤临床特点、治疗结果及预后因素，为今后的