中国实用外科杂志

中国实用外科杂志 ›› 2023, Vol. 43 ›› Issue (12): 1422-1428.DOI: 10.19538/j.cjps.issn1005-2208.2023.12.20

• 论著 • 上一篇    下一篇

原发性甲状腺淋巴瘤临床预后相关因素及生存研究

赵海鑫，耿祖仕，卢秀波   

  1. 郑州大学第一附属医院甲状腺外科，河南郑州450052
  • 出版日期:2023-12-01 发布日期:2024-02-22

  • Online:2023-12-01 Published:2024-02-22

摘要： 目的    分析原发性甲状腺淋巴瘤（PTL）的临床特征及影响原发性甲状腺弥漫大B细胞淋巴瘤（PTDLBCL）总生存率（OS）和无进展生存率（PFS）的相关因素。方法    回顾性分析2011—2022年郑州大学第一附属医院收治的74例Ann Arbor分期ⅠE～ⅡE期PTL病人临床资料，对其临床特征及治疗随访情况等进行描述性分析，对其中54例PTDLBCL病人进行生存分析，单因素分析采用Kaplan-Meier法和Log-rank检验，多因素分析采用Cox比例风险回归模型。结果    74例PTL病人，中位随访时间26（1～117）个月，1、3、5年OS为85.0%、78.4%、75.6%；1、3、5年PFS为76.5%、71.7%、63.1%。对PTDLBCL的多因素分析显示使用抗CD20单抗治疗（P=0.020）是OS的保护因素；采用以化疗为主加手术或放疗的综合治疗方法（P=0.046）以及使用抗CD20单抗治疗（P=0.003）是PFS的保护因素。结论    PTL病理类型主要为DLBCL。对于PTDLBCL病人，使用抗CD20单抗可延长其OS及PFS，应用化疗为主的综合方法治疗有助于延长其PFS。

关键词: 原发性甲状腺淋巴瘤, 弥漫大B细胞淋巴瘤, 预后, 无进展生存期

Abstract: Clinical prognostic factors and survival study of primary thyroid lymphoma: a single-center retrospective study        ZHAO Hai-xin, GENG Zu-shi, LU Xiu-bo. Department of Thyroid Surgery, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
Corresponding author：LU Xiu-bo,E-mail:doctorluxiubo@126.com
Abstract    Objective    To analyze the clinical features of primary thyroid lymphoma（PTL）and the related factors of primary thyroid diffuse large B cell lymphoma（PTDLBCL）affecting overall survival（OS）and progression-free survival（PFS）. Methods    The clinical data of 74 patients with PTL who were diagnosed with Ann Arbor stage ⅠE-ⅡE in the First Affiliated Hospital of Zhengzhou University from 2011 to 2022 were retrospectively collected.A descriptive analysis was carried out on the clinical features，treatment，and follow-up.54 patients with PTDLBCL were subjected to prognostic univariate analysis and multivariate analysis.Kaplan-Meier method and Log-rank test were used for univariate analysis and multivariate analysis using the Cox proportional hazards regression model. Results    The median follow-up time of 74 PTL patients was 26 months（range，1-117 months），and the 1-year，3-year，and 5-year OS were 85.0%，78.4%，and 75.6%；the 1-year，3-year，and 5-year PFS were 76.5%，71.7%，and 63.1%.Multivariate analysis shows that the use of anti-CD20 monoclonal antibody（P=0.020）is a protective factor for OS in patients with PTDLBCL；chemotherapy-based combined treatment with surgery or radiotherapy（P=0.046），and treatment with anti-CD20 monoclonal antibody（P=0.003）are the protective factors for PFS. Conclusion    The main pathological type of PTL is DLBCL.For PTDLBCL patients，therapy with anti-CD20 monoclonal antibody is more beneficial to improve the OS and PFS，comprehensive treatment with chemotherapy as the main treatment can help prolong the PFS.

Key words: primary thyroid lymphoma, diffuse large B-cell lymphoma, prognosis, progression-free survival