[34例原发性甲状腺淋巴瘤患者的临床特征和预后分析]

L Yang, L J Zeng, J Ye, L Q Wei, J Cong, X Li, N Yao, J Yang, H N Wang, L W Lyu, Y P Wu, L Wang
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摘要

目的:探讨原发性甲状腺淋巴瘤(PTL)的临床特征、诊断、治疗和预后:研究原发性甲状腺淋巴瘤(PTL)的临床特征、诊断、治疗和预后。方法回顾性分析2010年9月至2023年2月北京同仁医院收治的34例新诊断的原发性甲状腺淋巴瘤患者的临床和病理资料。采用Kaplan-Meier生存曲线和Log-rank检验进行生存分析,并采用Cox回归模型对预后因素进行单变量分析。结果34例PTL患者均以宫颈肿块为首发临床表现。其中男性 9 例,女性 25 例。病理诊断为弥漫大 B 细胞淋巴瘤(DLBCL)29 例,粘膜相关淋巴组织淋巴瘤(MALT)5 例。在 DLBCL 患者中,6 人有 B 型症状,17 人的东部合作肿瘤学组(ECOG)评分≥2 分,21 人的 Ann Arbor 分期为Ⅰ-Ⅱ期,8 人的Ⅲ-Ⅳ期,4 人的肿瘤直径≥10 厘米,14 人并发桥本甲状腺炎;27例接受化疗,21例获得完全缓解(CR),2例获得部分缓解(PR),6例疾病进展;5年无进展生存率和总生存率分别为78.5年无进展生存率和总生存率分别为78.9%和77.4%;单变量生存分析显示,B症状、肿瘤直径≥10厘米、Ann Arbor分期Ⅲ-Ⅳ期是影响患者预后的重要因素(PConclusion:PTL多见于并发桥本甲状腺炎的女性,病理类型以B细胞淋巴瘤居多。治疗以化疗为主,辅以放疗和手术,预后相对较好。
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[Clinical characteristics and prognostic analysis of 34 patients with primary thyroid lymphoma].

Objective: To investigate the clinical characteristics, diagnosis, treatment, and prognosis of primary thyroid lymphoma (PTL) . Methods: A retrospective analysis was conducted on the clinical and pathological data of 34 newly diagnosed PTL patients admitted to Beijing Tongren Hospital from September 2010 to February 2023. The Kaplan-Meier survival curve and Log-rank test were used for survival analysis, and the Cox regression model was applied for univariate analysis of prognostic factors. Results: All 34 PTL patients presented with cervical mass as the initial clinical manifestation. There were 9 males and 25 females. The pathological diagnosis was diffuse large B-cell lymphoma (DLBCL) in 29 patients and mucosa-associated lymphoid tissue (MALT) lymphoma in 5 patients. Among the DLBCL patients, 6 had B symptoms, 17 had an Eastern Cooperative Oncology Group (ECOG) score of ≥2, the Ann Arbor staging was stage Ⅰ-Ⅱ in 21 cases and stage Ⅲ-Ⅳ in 8 cases, the tumor diameter was ≥10 cm in 4 cases, and 14 had concurrent Hashimoto thyroiditis; 27 cases received chemotherapy, with 21 cases achieving complete remission (CR), 2 cases partial remission (PR), and 6 cases of disease progression; the 5-year progression-free survival and overall survival rates were 78.9% and 77.4%, respectively; univariate survival analysis showed that B symptoms, tumor diameter ≥10 cm, and Ann Arbor stage Ⅲ-Ⅳ were significant factors affecting patient prognosis (P<0.05). MALT lymphoma patients were all in stages Ⅰ-Ⅱ, had an ECOG score of 0-1, and were without B symptoms. All patients underwent surgical resection, with 4 cases achieving CR and 1 case PR. Conclusion: PTL is more common in females with concurrent Hashimoto thyroiditis, with the majority of pathological types being B-cell lymphoma. The main treatment is chemotherapy, supplemented by radiotherapy and surgery, and the prognosis is relatively favorable.

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