| Objective: non-Hodgkin lymphoma(NHL)is a heterogeneous malignant tumor with an increasing incidence year by year.Clinical data of non-Hodgkin lymphoma(NHL)patients admitted to A Region from January 2015 to August2022 were retrospectively analyzed.To summarize the clinical characteristics of NHL patients and analyze the factors affecting clinical staging,so as to provide reference for future clinical diagnosis and treatment.Methods: A total of 255 patients with NHL who were admitted to A Hospital from January 2015 to August 2022 and confirmed by imaging examination and pathological biopsy were reviewed and analyzed.Clinical data of the selected patients were complete.General clinical information including name,gender and age were collected.Blood test indicators: white blood cell count,hemoglobin count,platelet count,lymphocyte percentage,monocyte rate,lactate dehydrogenase.First symptoms,site of onset,pathological type,clinical stage,IPI score,number of involved lymph nodes,number of extranodal involvement,mediastinal lymph node invasion,systemic symptoms and ECOG score were recorded.Pathological types are based on the 2008 World Health Organization NHL classification.Clinical staging of lymphoma patients was performed by Ann Arbor staging(1971).SPSS25.0 software was used to statistical analysis,single factor analysis using 2 test,multiple factors analysis using Logistic regression method is analyzed,summarized the clinical features of patients with NHL and the influencing factors of clinical stage.Results:(1)Among the 255 patients with NHL,141 were males and 114 were females,with a ratio of 1.23:1.The youngest age of onset was 13 years old,the oldest age of onset was 85 years old and the median age was 58 years old.(2)Initial symptoms: The main systemic symptoms were fever and fatigue in 19cases(7.5%),including fever in 10 cases(3.9%)and fatigue in 9 cases(3.6%).A total of 46 patients(18.0%)showed symptoms of digestive system,including 42patients(16.4%)with abdominal pain,abdominal distension,3 patients(1.2%)with changes in stool characteristics,and 1 patient(0.4%)with bloody stool.96cases(37.5%)had lymph node enlargement or mass in different sites,69 cases(27.0%)had cervical lymph node enlargement,13 cases(5.1%)had inguinal lymph node enlargement,11 cases(4.3%)had axillary lymph node enlargement,and 3 cases(1.1%)had multi-site lymph node enlargement.Physical examination revealed 20 cases(8.0%)with space occupying in different anatomical parts,among which abdominal space occupying was the most common in 5 cases(2.0%).Central nervous system symptoms were the main symptoms in 15 cases(5.8%),and the most common symptoms were dizziness,headache,facial anesthesia,fatigue,9 cases(3.6%).Respiratory system related symptoms were manifested in 44 cases(17.2%): nasopharyngeal clinical symptoms were common,including nasal congestion,runny nose and nosebleed in 15 cases(5.7%);pharyngeal symptoms included foreign body sensation in 10cases(3.9%)and pharyngeal pain in 6 cases(2.4%).(3)Site of onset: There were 117 cases of intradermal onset,accounting for 45.8%.The most common intradermal onset was cervical and supraclavicular lymph nodes,accounting for28.3%(72/255),followed by inguinal lymph nodes,5.0%(14/255)and abdominal and retroperitoneal lymph nodes,4.3%(11/255).The other 138 patients had extrinsic onset,accounting for 54.1%,and gastrointestinal tract was the most common site,accounting for 12.5%(32/255).(4)In B-cell lymphoma patients,stage Ⅰ and Ⅱ accounted for 25.8%(55/213),stage Ⅲ and Ⅳaccounted for 74.2%(158/213),stage Ⅰ and Ⅱ accounted for 42.9%(18/42),stage Ⅲ and Ⅳ accounted for 57.1%(24/42),respectively.The proportion of stage Ⅲ and Ⅳ in B-cell lymphoma patients was significantly higher than that in T-cell lymphoma(P < 0.05).Mediastinal lymph node invasion accounted for26.8%(57/213)of B-cell lymphoma patients,mediastinal lymph node invasion accounted for 47.6%(20/42)of T-cell lymphoma patients,and mediastinal lymph node invasion was more likely to occur in T-cell lymphoma patients(P <0.05).(5)In the 255 cases of NHL patients,the clinical data of stage Ⅰ,stage Ⅱaccounted for 28.6%(73/255),stage Ⅲ,stage Ⅳ accounted for 71.4%(182/255);Univariate analysis of variance showed that gender,pathological type,affected lymph node region,ECOG score,Hemoglobin,monocyte rate,lactate dehydrogenase,and systemic symptoms were all factors affecting the clinical staging of patients.Multivariate analysis showed that gender,pathological type,lymph node region involved,hemoglobin,lactate dehydrogenase,and systemic symptoms were factors that affected clinical staging of NHL patients.Conclusions:(1)We analyzed the largest series of lymphoma in Guilin,Guangxi,with T cell tumors in 16.5% of 225 cases of NHL.The relative frequencies of the main types of NHL in this group were similar to other regions in the country with only a small difference,but the overall pattern was completely different from that of Western countries.(2)In this study,the middle-aged and elderly people were the main population of NHL,and the incidence of male was significantly higher than that of female.B-cell lymphoma was more common than T-cell lymphoma.Cervical and supraclavicular lymph nodes were the main sites of intraldynodal onset,while gastrointestinal tract and Welshite ring were the main sites of extraldynodal onset.Diffuse large B-cell lymphoma was the most common pathological type,and there were more patients in stage Ⅲ and Ⅳ than stage Ⅰ and stage Ⅱ.(3)NHL gender,pathological type,affected lymph node region,hemoglobin,lactate dehydrogenase,and systemic symptoms in this study were factors affecting the clinical staging of NHL patients. |
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