【摘要】：目的：將探討我院原發(fā)性宮頸惡性淋巴瘤(primary cervical lymphoma, PCL)的病理亞型,分期和臨床表現(xiàn)特征、診斷手段、綜合治療及影響生存預(yù)后的因素,進(jìn)一步了解宮頸淋巴瘤的臨床病理特性,以探討綜合治療手段在宮頸原發(fā)性惡性淋巴瘤治療中的優(yōu)化模式及預(yù)后。材料與方法：本研究為臨床資料回顧性分析,本研究通過(guò)入組1992年12月～2009年8月37例我院收治的原發(fā)性宮頸惡性淋巴瘤患者。對(duì)所有符合入組標(biāo)準(zhǔn)的患者,記錄患者的一般信息、隨訪患者目前的病情。所有患者都詳細(xì)詢問(wèn)病史、體檢、血常規(guī)、肝腎功能、胸片、腹部B超或Computed Tomography(CT)檢查,除外非宮頸原發(fā)淋巴瘤累及宮頸,必要時(shí)行骨髓穿刺或活檢,病理診斷都經(jīng)我院病理科行免疫組化確診。最后對(duì)所獲取的數(shù)據(jù)進(jìn)行統(tǒng)計(jì)分析。應(yīng)用SPSS17.0軟件包建立數(shù)據(jù)庫(kù),生存率采用Kaplan-Meier方法計(jì)算,應(yīng)用x2檢驗(yàn)分析,P0.05為差異有統(tǒng)計(jì)學(xué)意義,分析宮頸惡性淋巴瘤的臨床特征、治療及預(yù)后。結(jié)果：37例原發(fā)性宮頸惡性淋巴瘤患者有36例完成了臨床隨訪(隨訪率97.3%),36例患者隨訪至2013年3月共33例存活,3例死亡,4例復(fù)發(fā)。到目前為止,中位隨訪時(shí)間67.5個(gè)月(2-204)個(gè)月,中位總生存期(Overall Survival, OS):87個(gè)月,中位無(wú)病生存期(Disease Free Survival, DFS):67.5個(gè)月(2-204個(gè)月)。5年生存率94.3%,10年生存率90.7%。結(jié)論：本病需與宮頸慢性炎性反應(yīng)、宮頸淋巴瘤樣病變、宮頸癌及子宮頸原發(fā)未分化小細(xì)胞癌(神經(jīng)內(nèi)分泌癌)相鑒別。原發(fā)性宮頸惡性淋巴瘤的治療包括手術(shù)、放療、化療及免疫治療,通常預(yù)后較好。臨床分期越早預(yù)后越好,MALT淋巴瘤比其他類型淋巴瘤預(yù)后好。本病的發(fā)生可能與遺傳因素有關(guān)。臨床分期、病理分型及治療方法等是預(yù)后的影響因素。
[Abstract]:Objective: to investigate the pathological subtypes, staging, clinical features, diagnostic methods, comprehensive treatment and factors affecting survival and prognosis of primary cervical malignant lymphoma (primary cervical lymphoma, PCL) in our hospital. To investigate the clinicopathological characteristics of cervical lymphoma and to explore the optimal treatment mode and prognosis of cervical primary malignant lymphoma. Materials and methods: this study was a retrospective analysis of clinical data. From December 1992 to August 2009 37 patients with primary cervical malignant lymphoma were treated in our hospital. For all patients who meet the admission criteria, record general information of the patient and follow up the patient's current condition. All patients were asked for medical history, physical examination, blood routine examination, liver and kidney function, chest radiography, abdominal B-ultrasound or Computed Tomography (CT) examination, except non-cervical primary lymphoma involving the cervix, bone marrow puncture or biopsy, when necessary, The pathological diagnosis was confirmed by immunohistochemistry in our department of pathology. Finally, the obtained data are statistically analyzed. The survival rate was calculated by Kaplan-Meier method and analyzed by x2 test. The difference was statistically significant (P0.05). The clinical features, treatment and prognosis of cervical malignant lymphoma were analyzed. Results: 36 cases (97.3%) of 37 patients with primary malignant lymphoma of cervix were followed up. 33 cases survived, 3 cases died and 4 cases recurred. So far, median follow-up time was 67.5 months (2-204) months, median total survival time (Overall Survival, OS):) was 87 months, median disease-free survival period (Disease Free Survival,) was 87 months. DFS): was 67.5 months (2-204 months). The 5-year survival rate was 94. 3 months, and the 10-year survival rate was 90. 7%. Conclusion: this disease should be distinguished from chronic inflammatory reaction of cervix, lymphomatous lesion of cervix, cervical carcinoma and primary undifferentiated small cell carcinoma of cervix (neuroendocrine carcinoma). The treatment of primary malignant lymphoma of the cervix includes surgery, radiotherapy, chemotherapy and immunotherapy. The earlier the clinical stage, the better the prognosis. MALT lymphoma has a better prognosis than other types of lymphoma. The occurrence of this disease may be related to genetic factors. Clinical staging, pathological classification and treatment are the prognostic factors.
【學(xué)位授予單位】：復(fù)旦大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R737.33

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