• 主题
高级搜索  >
历史搜索 清空历史
首页> 中文期刊> 《湖南师范大学学报（医学版）》 >儿童恶性淋巴瘤95例临床分析

儿童恶性淋巴瘤95例临床分析

         
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

Objective To explore the clinical features of childhood malignant lymphoma. Methods 95 cases of childhood malignant lymphoma were selected from the files in period of 2001 to 2017 year, which would be statistically analyzed by us-ing Pearson test, multiple logistic regression analysis and Kaplan-Meier method. Results Most children in these cases were from rural area, which accounted for 68.42% (65/95). It was showed in all cases that there were 70 cases of male and 25 cases of female, and the M/F ratio was 2.8: 1, with a median age of 8. There are 55 cases (57.89%) in lymph node, 40 cases (42.11%) in extra-node, among which the gastrointestinal tract was the most. The location of Hodgkin lymphoma is remarkably lymph node, the different between Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL) was statistically significance.13 cases (13.86%) belonged to HL, and 82 cases (86.32%) belonged to NHL. Pathology type in HL mainly was classical Hodgkin lym-phoma. The most common was lymphoblastic lymphoma in NHL, and then were diffusing large B-cell lymphoma and Burkitt lymphoma. The clinical stages were more common in the middle and late stages, there were 34 cases (35.79%) belonged to Ⅰand Ⅱ stage, and 61 cases (64.21%) belonged to Ⅲand Ⅳ stage. The difference of expression of Ki-67 in malignant lym-phoma Ⅰ+Ⅱstages and Ⅲ+Ⅳ stages was statistically significance. Single factor analysis showed that B-symptom and LDH were significantly correlated with clinical stages, while patients' age and location were independent in clinical stages. Multiple factor analysis showed that LDH influenced on the clinical stages. In this study, the misdiagnosis rate of childhood malignant lymphoma was 36.84% (35/95, in which the more cases were misdiagnosed lymphrnoditis, accounting for 42.86% (15/35), and then were scrofula and upper respiratory tract infection. Analyzing the survival condition of 95 cases by using Kaplan-Meier method, the overall survival time range from 0 to 120 months, and the 5 years overall survival rate of 95 children was 67.70%. Conclusion NHL plays a major part of childhood malignant lymphoma. Male childhood are more common above six years old. The most common pathological types are lymphoblastic lymphoma, diffusing large B-cell lymphoma and Burkitt lymphoma. The early clinical manifestation of childhood malignant lymphoma was untypical, which easily causes misdiagnoses. LDH at primary diagnosis influences on clinical stages. Ki-67 is mainly expressed on Ⅲ and Ⅳ stages of childhood malignant lymphoma.%目的:探讨儿童恶性淋巴瘤的临床特点.方法:收集2001年~2017年期间确诊的95例恶性淋巴瘤患儿临床资料,并通过Pearson检验、多因素logistic回归分析、Kaplan-Meier分析法对95例患儿的临床资料进行统计分析.结果:95例儿童恶性淋巴瘤中,大部分来自农村地区,占68.42%(65/95).全组资料显示:男70例,女25例,男女比例2.8:1,中位发病年龄为8岁.淋巴结内起病55例(57.89%),淋巴结外起病40例(42.11%),结外以胃肠道起病常见.霍奇金淋巴瘤(HL)与非霍奇金淋巴瘤(NHL)起病部位差异有统计学意义,HL明显以结内起病为主.HL 13例(13.68%),NHL 82例(86.32%),病理类型HL以经典型霍奇金淋巴瘤为主;NHL以淋巴母细胞淋巴瘤最常见,其次为弥漫性大B细胞淋巴瘤和伯基特淋巴瘤.临床分期以中晚期多见,Ⅰ、Ⅱ期34例(35.79%),Ⅲ、Ⅳ期61例(64.21%).Ki-67在淋巴瘤Ⅰ、Ⅱ期及Ⅲ、Ⅳ期中的表达差异有统计学意义.单因素分析显示,B症状、血清LDH水平对临床分期有显著相关,而年龄、起病部位对临床分期无关.多因素回归分析显示,血清LDH水平为临床分期的影响因素.本研究中儿童恶性淋巴瘤误诊率为36.84%(35/95),最常见误诊为淋巴结炎,占42.86%(15/35),其次为淋巴结核及上呼吸道感染.95例患儿生存情况采用Kaplan-meier法分析,总体生存时间范围为0~120月,总体5年生存率为67.70%.结论:儿童恶性淋巴瘤以NHL为主,6岁以上男性儿童多见;最常见的病理类型为淋巴母细胞淋巴瘤、弥漫性大B细胞淋巴瘤及伯基特淋巴瘤.儿童恶性淋巴瘤早期临床表现不典型,易误诊.初诊时血清LDH水平是临床分期的影响因素,Ki-67高表达在Ⅲ、Ⅳ期恶性淋巴瘤中多见.

著录项

  • 来源
    《湖南师范大学学报（医学版）》 |2018年第2期|42-46|共5页
  • 作者

    曾敏慧; 贺湘玲; 邓绍阳; 袁小叶; 朱呈光; 陈可可; 邹润英; 龚军;

  • 作者单位

    湖南师范大学第一附属医院,湖南省人民医院儿童医学中心,长沙 410005;

    湖南师范大学第一附属医院,湖南省人民医院儿童医学中心,长沙 410005;

    湖南师范大学第一附属医院,湖南省人民医院儿童医学中心,长沙 410005;

    湖南师范大学第一附属医院,湖南省人民医院儿童医学中心,长沙 410005;

    湖南师范大学第一附属医院,湖南省人民医院儿童医学中心,长沙 410005;

    湖南师范大学第一附属医院,湖南省人民医院儿童医学中心,长沙 410005;

    湖南师范大学第一附属医院,湖南省人民医院儿童医学中心,长沙 410005;

    湖南师范大学第一附属医院,湖南省人民医院儿童医学中心,长沙 410005;

  • 原文格式 PDF
  • 正文语种 chi
  • 中图分类 网状内皮系统肿瘤;
  • 关键词

    淋巴瘤; 临床特征; 病理类型; 儿童;

相似文献

  • 中文文献
  • 外文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号