62例原发性乳腺弥漫大B细胞淋巴瘤临床病例分析
Retrospective analysis of clinical characteristics and prognostic factors of primary breast diffuse large B-cell lymphoma
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摘要:目的 探讨原发性乳腺弥漫大B细胞淋巴瘤(primary breast diffuse large B-cell lymphoma, PBDLBCL)的临床病理特点、治疗方案及预后。方法 收集湖南省人民医院、湖南省肿瘤医院和邵阳珂信肿瘤医院2006年1月至2016年12月62例PBDLBCL患者的临床病理资料, 采用Kaplan-Meier法进行单因素分析, 多因素分析采用Cox回归模型。结果 62例患者均为女性, 年龄26~71岁, 中位年龄47岁。随访6~105个月, 3年患者总生存率(overall survival, OS)为71.0%, 5年OS为51.0%。单因素生存分析显示, 临床分期、IPI评分、化疗方案、Ki-67、LDH水平、Myc/Bcl-2蛋白共表达的患者3、5年OS差异具有统计学意义(P < 0.05)。Cox回归模型多因素分析结果显示, Myc/Bcl-2蛋白共表达为影响患者预后的独立因素。结论 Myc/Bcl-2蛋白共表达为影响患者预后的独立因素, 治疗仍以免疫化疗为主, 结合局部放疗。Abstract:Objective To study the clinical and pathological characteristics and prognostic factors of primary breast diffuse large B-cell lymphoma (PBDLBCL).Methods Clinical and pathological data of 62 patients with PBDLBCL from January 2006 to December 2016 were retrospectively analyzed.The Kaplan-Meier method was used for univariate analysis and the Cox regression model for multivariate analysis.Results The 62 patients analyzed included women aged 26-71 years, with a median age of 47 years.Patients were followed up from 6 to 105 months; the 3-year overall survival (OS) rate was 71.0%, and 5-year OS rate was 51.0%.The univariate analysis showed statistically significant differences in the clinical stage, lactic acid dehydrogenase level, International Prognostic Index score, Myc/Bcl-2 protein expression, and chemotherapy regimen at 3 and 5 years associated with OS rates.The multivariate analysis showed that Myc/Bcl-2 protein expression was an independent prognostic factor of OS.Conclusions Comprehensive treatment with chemotherapy and radiotherapy is appropriate for PBDLBCL.Myc/Bcl-2 protein expression is an independent adverse prognostic factor for PBDLBCL.
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