国际肿瘤学杂志

国际肿瘤学杂志 ›› 2020, Vol. 47 ›› Issue (3): 157-163.doi: 10.3760/cma.j.issn.1673-422X.2020.03.006

• 论著 • 上一篇    下一篇

原发上呼吸消化道外结外NK/T细胞淋巴瘤的临床特征及生存分析

齐菲, 董梅()   

  1. 国家癌症中心 国家癌症临床研究中心 中国医学科学院北京协和医学院肿瘤医院内科 100021
  • 收稿日期:2020-01-23 修回日期:2020-02-02 出版日期:2020-03-08 发布日期:2020-05-27
  • 通讯作者: 董梅 E-mail:dongmei030224@163.com

Clinical characteristics and survival analysis of extra-upper aerodigestive tract extranodal NK/T-cell lymphoma

Qi Fei, Dong Mei()   

  1. Department of Medical Oncology, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
  • Received:2020-01-23 Revised:2020-02-02 Online:2020-03-08 Published:2020-05-27
  • Contact: Dong Mei E-mail:dongmei030224@163.com

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摘要：

目的 分析原发上呼吸消化道外结外NK/T细胞淋巴瘤(EUADT-ENKTCL)患者的临床特征及生存预后情况。方法 收集自2000年至2015年SEER数据库登记的779例结外NK/T细胞淋巴瘤(ENKTCL)患者的临床及生存资料,其中原发上呼吸消化道结外NK/T细胞淋巴瘤(UADT-ENKTCL)患者622例,EUADT-ENKTCL患者157例。对EUADT-ENKTCL患者的临床特征、生存情况及预后因素进行分析。结果 EUADT-ENKTCL患者中位发病年龄为55岁,男女比例为1.85∶1。相较于UADT-ENKTCL,EUADT-ENKTCL患者中T细胞来源(χ 2=18.916,P<0.001)、晚期病变(χ 2=63.669,P<0.001)、伴随B症状(χ 2=14.657,P=0.001)以及接受单纯化疗(χ 2=71.412,P<0.001)更多见。EUADT-ENKTCL可原发于全身不同器官组织,其中皮肤或皮下软组织最多见(38.2%,60/157),其次依次为胃肠道(18.5%,29/157)、肺/胸膜(13.4%,21/157)、睾丸(6.4%,10/157)和眼眶(5.1%,8/157)等。EUADT-ENKTCL患者中位总生存时间(OS)和5年OS率分别为8.0个月和24.0%,明显劣于UADT-ENKTCL患者(31.0个月和43.5%; χ 2=32.080,P<0.001)。单因素分析结果提示晚期、肺原发病变的EUADT-ENKTCL患者预后更差,多因素分析证实临床分期是影响OS的预后因素(Ⅲ~Ⅳ期 vs.Ⅰ~Ⅱ期,HR=2.078,95%CI为1.335~3.234,P=0.001)。结论 EUADT-ENKTCL是一类高度侵袭性疾病,与UADT-NKTCL相比,存在临床特征的差异性且长期生存不理想。

关键词: 淋巴瘤, 结外NK-T细胞, 生存, 预后, 上消化呼吸道外

Abstract:

Objective To analyze the clinical characteristics, survival outcome and prognostic factors of patients with extra-upper aerodigestive tract extranodal NK/T-cell lymphoma (EUADT-ENKTCL). Methods We collected the clinical data of 779 patients with ENKTCL who were registered in SEER (Surveillance, Epidemiology, and End Results) database from 2000 to 2015 including 622 cases diagnosed with upper-aerodigestive tract extranodal NK/T-cell lymphoma (UADT-ENKTCL) and 157 cases with EUADT-ENKTCL. Clinical characteristics, survival outcome and prognostic factors were analyzed in EUADT-ENKTCL patients. Results The median age of patients with EUADT-ENKTCL was 55. The ratio of male to female was 1.85∶1. Compared with UADT-ENKTCL, patients with EUADT-ENKTCL accounted a higher proportion of malignant T-cell origin (χ 2=18.916, P<0.001), advanced stage disease (χ 2=63.669, P<0.001), accompanied B symptoms (χ 2=14.657, P=0.001) and receiving chemotherapy alone (χ 2=71.412, P<0.001). EUADT-ENKTCL could be originated in different organs and tissues throughout the body, among which the skin or subcutaneous soft tissues was the most common locations (38.2%, 60/157), followed by gastrointestinal tract (18.5%, 29/157), lung/pleura (13.4%, 21/157), testis (6.4%, 10/157), orbit (5.1%, 8/157) and others. The median overall survival (OS) was 8.0 months and 5-year OS rate was 24.0% for the EUADT-ENKTCL cohort, which were much inferior to those of UADT-ENKTCL patients (31.0 months and 43.5%; χ 2=32.080, P<0.001). Univariate analysis showed that patients with advanced stage or primary lung disease of EUADT-ENKTCL had unfavorable OS. Stage was a prognostic factor of OS via multivariate analysis (Ⅲ/Ⅳ vs. Ⅰ/Ⅱ, HR=2.078, 95%CI: 1.335-3.234, P=0.001). Conclusion EUADT-ENKTCL is a highly aggressive malignancy. Compared with UADT-ENKTCL, EUADT-ENKTCL patients have different clinical characteristics and significantly inferior OS.

Key words: Lymphoma, extranodal NK-T-cell, Survival, Prognosis, Extra-upper aerodigestive tract