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目的探讨原发性宫颈恶性淋巴瘤(primary cervical lymphoma,PCL)临床特点、治疗方法及预后因素。方法 2000年1月至2009年12月天津医科大学附属肿瘤医院收治8例PCL,总结其年龄、症状、体征、胸片和(或)CT、盆腔B超和(或)CT和(或)MRI、阴道镜、骨髓分类、治疗方法、生存时间等临床资料,并结合国内外文献进行分析。结果 2000年至2009年间天津市平均人口数中PCL的发病率为7.53/1000万。8例患者中位年龄45.5岁,均为非霍奇金淋巴瘤,B细胞型7例,包括弥漫大B细胞淋巴瘤6例;T细胞型1例。年龄≥60岁与<60岁平均生存12.3个月和48.4个月;肿瘤直径≥3.5cm与<3.5cm者平均生存28.0个月和46.3个月;小淋巴细胞淋巴瘤、外周T细胞淋巴瘤和弥漫大B细胞淋巴瘤平均生存87、54和23个月;乳酸脱氢酶(LDH)升高与正常者平均生存15.0、37.7个月;β2微球蛋白(β2-MG)升高与正常者平均生存15.0、37.7个月;手术+化疗、化疗+放疗、单纯化疗的平均生存期分别为38.3、40.0和28.7个月。结论 PCL临床罕见,临床表现不典型,病理类型主要为弥漫大B细胞淋巴瘤,年龄、肿瘤大小、病理类型、LDH、β2-MG、治疗方式等因素可能与预后相关。
Objective To investigate the clinical features, treatment and prognostic factors of primary cervical lymphoma (PCL). Methods Eight patients with PCL were enrolled in the Tumor Hospital Affiliated to Tianjin Medical University from January 2000 to December 2009, and their age, symptoms, signs, chest radiographs and / or CT, pelvic B-ultrasound and / or CT and / or MRI , Colposcopy, bone marrow classification, treatment, survival time and other clinical data, combined with domestic and foreign literature analysis. Results The incidence of PCL among the average population in Tianjin from 2000 to 2009 was 7.53 / 10 million. Among the 8 patients, the median age was 45.5 years, all of whom were non-Hodgkin’s lymphoma. There were 7 B-cell types, including 6 diffuse large B-cell lymphoma and 1 T cell type. The mean survival time was 12.3 months and 48.4 months for patients ≥60 years old and <60 years old. The average survival time was 28.0 months and 46.3 months for patients with tumor diameter ≥3.5cm and <3.5cm. Small lymphocytic lymphoma, peripheral T cell lymphoma and Patients with diffuse large B-cell lymphoma survived for an average of 87, 54 and 23 months respectively. Elevated lactate dehydrogenase (LDH) and normal survival rate were 15.0 and 37.7 months respectively. Elevated β2-microglobulin (β2-MG) Average survival 15.0,37.7 months; surgery + chemotherapy, chemotherapy + radiotherapy, chemotherapy alone mean survival of 38.3,40.0 and 28.7 months. Conclusions The clinical manifestations of PCL are rare and the clinical manifestations are not typical. The main pathological types are diffuse large B-cell lymphoma. The age, tumor size, pathological type, LDH, β2-MG, and treatment may be related to prognosis.