中华皮肤科杂志 ›› 2011, Vol. 44 ›› Issue (9): 611-614.

• 论著 •    下一篇

36例皮肤天然杀伤细胞/T细胞淋巴瘤临床病理学研究

徐教生1,李敏2,黄欣1,张永红3,周春菊3,薛学敏4,段泽君1,孙琳1,刘翠苓4,高子芬5   

  1. 1. 北京大学医学部基础病理学系
    2. 北京大学医学部病理学系
    3. 北京儿童医院
    4.
    5. 北京大学基础医学院病理学系
  • 收稿日期:2011-01-19 修回日期:2011-02-20 出版日期:2011-09-15 发布日期:2011-08-31
  • 通讯作者: 高子芬 E-mail:wjshgao@bjmu.edu.cn
  • 基金资助:

    NK/T细胞淋巴瘤基因谱研究;儿童非霍奇金淋巴瘤分层治疗及残留病监测

Clinicopathological analysis of cutaneous natural killer/T cell lymphoma: 36 case report

  • Received:2011-01-19 Revised:2011-02-20 Online:2011-09-15 Published:2011-08-31

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摘要：

目的 探讨皮肤天然杀伤细胞（NK）/T细胞淋巴瘤临床病理学特点、与EB病毒的关系及预后。 方法 收集2000—2010年北京大学医学部病理学系确诊为皮肤NK/T细胞淋巴瘤36例，分为原发与继发两组，分别观察临床病理学特点及与EB病毒的关系，并进行随访。结果 36例皮肤NK/T细胞淋巴瘤中，原发13例，继发20例，未能明确原发或继发3例。原发性与继发性皮肤NK/T细胞淋巴瘤均以男性好发，但两组男女性别比差异无统计学意义（P > 0.05）。与原发者相比，继发者发病年龄早（中位年龄，43.5比54 岁，P < 0.05）、且临床上出现B症状（包括发热、盗汗或体质量下降）及多发皮损改变的频率较高（P值分别为< 0.05和< 0.01）。EB病毒在原发和继发病例中的检出率类似，分别为92.3%和85%。36例皮肤NK/T细胞淋巴瘤中位生存期为8个月，其中继发性皮肤NK/T细胞淋巴瘤中位生存期为6个月，明显短于原发者（18个月，χ2 = 6.074，P < 0.05）。结论 皮肤NK/T细胞淋巴瘤是一组与EB病毒密切相关、临床侵袭性强的肿瘤。但原发者较继发者发病年龄晚、预后较好。

关键词: 预后

Abstract:

Objective To investigate the clinicopathological features and prognosis of natural killer （NK）/T cell lymphoma and to analyze its relationship with Epstein-barr virus （EBV）. Methods Totally, 36 cases of cutaneous NK/T cell lymphoma were collected from 2000 to 2010 at the Department of Pathology, Peking University Health Science Center, and classified into primary and secondary groups according to whether there is evidence of extracutaneous involvement within 6 months after diagnosis. Clinicopathological features were analyzed and Epstein-barr virus （EBV） was detected. Results Of these 36 cases, 13 （36.1%） were classified as primary cutaneous NK/T cell lymphoma, 20 （55.6%） as secondary, and 3 （8.3%） remained unclassified because of the lack of clinical data. Males were more likely to develop both primary and secondary cutaneous NK/T cell lymphoma than females, but there was no striking difference in sex ratio between the patients with primary and secondary lymphoma（P > 0.05）. Compared with the patients with primary cutaneous NK/T cell lymphoma, those with secondary cutaneous NK/T cell lymphoma showed a younger median age at onset （43.5 vs. 54 years, P < 0.05）, higher prevalence of B symptoms （including fever, night sweat, body weight loss） and multiple skin lesions （P < 0.05 and 0.01, respectively）. EBV was positive in 92.3% （12/13） of the primary lymphoma cases and 85% （17/20） of the secondary lymphoma cases. Moreover, the median survival was 8 months in all the cutaneous NK/T cell lymphoma cases, and was significantly shorter in secondary cases than in the primary cases （6 vs. 18 months, χ2 = 6.074, P < 0.05）. Conclusions Cutaneous NK/T cell lymphoma is an EBV-associated, clinically aggressive disease entity. Patients with primary cutaneous NK/T cell lymphoma seem to have an older age at onset and a better prognosis as compared with those with secondary cutaneous NK/T cell lymphoma.

Key words: Survival analysis

中图分类号: 

  • R365