微信公众号

官网二维码
中国癌症防治杂志

中国癌症防治杂志 ›› 2017, Vol. 9 ›› Issue (3): 209-213.doi: 10.3969/j.issn.1674-5671.2017.03.10

• 临床研究 • 上一篇    下一篇

9例原发睾丸弥漫大B细胞淋巴瘤临床特点及预后分析

  

  1. 广西医科大学第一附属医院肿瘤内科
  • 出版日期:2017-06-25 发布日期:2017-08-02
  • 通讯作者: 彭志刚 Drpzg001@163.com
  • 基金资助:

    广西自然科学基金资助项目（02601214007C）

Primary testicular diffuse large B-cell lymphoma：series of 9 cases

  • Online:2017-06-25 Published:2017-08-02

PDF (PC)

434

赞

被引次数

8

摘要：

目的　探讨原发睾丸弥漫大B细胞淋巴瘤（primary testicular diffuse large B-cell lymphoma，PTDLBCL）的临床特征、治疗及预后。方法 回顾性分析我院2013年1月至2016年12月确诊的9例PTDLBCL患者的临床资料。结果 9例患者中位发病年龄为64岁（50～72岁），以右侧睾丸受累为主；Ann Arbor分期以早期为主，其中Ⅰ期6例，Ⅲ期1例，Ⅳ期2例；细胞来源以非生发中心来源为主，非生发中心B细胞来源7例，生发中心B细胞来源2例；肿瘤增殖指数Ki-67偏高，Ki-67中位数为80%。治疗以手术加术后辅助化疗为主，其中单纯手术治疗1例，手术联合CHOP方案为主的化疗8例。获完全缓解6例，部分缓解2例，疾病进展1例。随访时间5～34个月，存活6例，死亡3例。结论 原发睾丸弥漫大B细胞淋巴瘤是一组罕见的疾病，复发风险高，一线治疗方案推荐患侧睾丸根治性切除术后联合Ｒ-CHOP方案化疗，同时对对侧睾丸及受累野进行放疗及预防性甲氨蝶呤鞘内化疗。

关键词: 淋巴瘤, 原发睾丸弥漫大B细胞淋巴瘤, 化疗, 临床特点, 预后

Abstract:

Objective To analyze the clinical characteristics，outcomes and treatment strategies of a case series of patients with primary testicular diffuse large B-cell lymphoma（PTDLBCL）. Methods Various clinical parameters were analyzed in 9 patients with PTDLBCL diagnosed from January 2013 to September 2016 in our hospital. Results Median age at diagnosis was 64 years （range，50-72）. Cases involved mainly the right testicle，and cells of origin were  non-GCB subtype（7 patients） or GCB subtype（2 patients）.Median rate of Ki-67 expression was 80%.One patient underwent surgery only，while seven had surgery followed by chemotherapy. Six patients showed complete response；two，partial response；and one，progression.Six patients were alive，corresponding to follow-up ranging from 5 to 34 months. Conclusion PTDLBCL has high recurrence risk. We suggest first-line treatment involving 6-8 cycles of anthracycline-based chemotherapy and rituximab treatment，central nervous system prophylaxis and contralateral testicular radiation after surgery.

Key words:  Lymphoma, Primary testicular diffuse large B-cell lymphoma, Chemotherapy, Clinical characteristic, Prognosis