62例原发性乳腺弥漫大B细胞淋巴瘤临床病例分析

易嘉宁; 范培芝; 范舟; 易平勇; 陈帅; 杜洋

doi:10.3969/j.issn.1000-8179.2019.12.620

62例原发性乳腺弥漫大B细胞淋巴瘤临床病例分析

doi: 10.3969/j.issn.1000-8179.2019.12.620

易嘉宁^①,,
范培芝^①, ,,
范舟^②,
易平勇^③,
陈帅^①,
杜洋^①

①.
湖南省人民医院乳甲外科（长沙市410002）
②.
湖南省肿瘤医院检验科
③.
邵阳珂信肿瘤医院肿瘤内科

详细信息

作者简介:
易嘉宁专业方向为乳腺恶性肿瘤的研究。E-mail：yijianing10@163.com

通讯作者:
范培芝 Fanpzh64@163.com

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出版历程
- 收稿日期: 2019-04-29
- 修回日期: 2019-06-11
- 刊出日期: 2019-06-30

Retrospective analysis of clinical characteristics and prognostic factors of primary breast diffuse large B-cell lymphoma

Yi Jianing^{①
,},
Fan Peizhi^{①
, ,},
Fan Zhou^②,
Yi Pingyong^③,
Chen Shuai^①,
Du Yang^①

①.
Surgical Department of Breast and Thyroid Gland, Hunan Provincial People's Hospital, Changsha 410002, China
②.
Clinical Laboratory, Hunan Cancer Hospital, Changsha 410002, China
③.
Department of Medical Oncology Shao Yang Kexin Cancer Hospital, Shaoyang 422000, China

More Information

Corresponding author: Peizhi Fan; E-mail: Fanpzh64@163.com

摘要

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。
- 乳腺肿瘤 /
- 淋巴瘤 /
- 临床特征 /
- 预后
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.
- breast neoplasm /
- diffuse large B-cell lymphoma /
- clinical characteristics /
- prognosis

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图 1 镜下病理组织学图

A：H&E染色（×100）；B：H&E染色（×200）；C：H&E染色（×400）；D：Ki-67阳性（×200）；E：c-myc阳性（×200）；F：CD79a阳性（×200）G：CD20阳性（× 200）；H：CD10阳性（×200）；I：Mun1阳性（×200）；J：Bcl-6阳性（×200）；K：Bcl-2阳性（×200）；L：CD3阴性（×200）

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图 2 62例PBDLBCL患者的OS曲线

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表 1 影响PBDLBCL患者预后的单因素分析

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