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目的:探讨原发骨淋巴瘤(PBL)和继发骨淋巴瘤(SBL)的临床特点和预后的差异。方法:收集并分析38例原发和继发的骨淋巴瘤患者,其中PBL 14例,SBL 24例,对其临床特征和预后进行分析总结。结果:在PBL和SBL中均以弥漫大B细胞淋巴瘤(DLBCL)最多见(85.7%、83.3%)。PBL患者中骨痛症状突出(85.7%),多灶骨累及较常见(64.3%),与SBL患者比较,早期患者多见(P=0.004),IPI评分较低(P=0.037)。PBL和SBL常见的骨累及部位均为脊柱(50.0%、62.5%)和骨盆(57.1%、50.0%)。PBL患者总生存率显著优于SBL患者(P<0.05)。单因素预后分析显示,患者获得完全缓解与生存时间延长显著相关。结论:DLBCL是PBL和SBL中最常见的亚型。PBL的预后优于SBL,仅治疗是否获得完全缓解与骨淋巴瘤患者的生存预后相关。
Objective: To investigate the clinical features and prognosis of primary bone lymphoma (PBL) and secondary bone lymphoma (SBL). Methods: Thirty-eight patients with primary and secondary bone lymphoma were collected and analyzed, including 14 cases of PBL and 24 cases of SBL. The clinical features and prognosis were analyzed and summarized. Results: Most cases of diffuse large B-cell lymphoma (DLBCL) were seen in both PBL and SBL (85.7%, 83.3%). In PBL patients, the symptoms of bone pain were prominent (85.7%) and multifocal bone involvement was common (64.3%). Compared with SBL patients, the early patients were more common (P = 0.004) and the IPI scores were lower (P = 0.037). The common bone involvement sites in PBL and SBL were spine (50.0%, 62.5%) and pelvis (57.1%, 50.0%). The overall survival rate of PBL patients was significantly better than that of SBL patients (P <0.05). Univariate prognostic analysis showed that patients with complete remission were significantly associated with prolonged survival. Conclusion: DLBCL is the most common subtype in PBL and SBL. The prognosis of PBL is superior to that of SBL, and only whether complete remission is associated with survival prognosis of patients with bone lymphoma.