An Analysis Of Clinical Feature And Therapeutic Assessment Of297Case Of Non-hodgkin’s Lymphoma

Objective: To understand the clinical characteristics of non-Hodgkin lymphoma(NHL) patients admitted in First Affiliated Hospital of Nanhua University in the past10years; all the clinical data were revaluated by2008year edition of WHOlymphoma classification and Ann Arbor clinical staging system to provide the basisfor establishment of comparable clinical data for the NHL staging, classification, andtherapeutic efficacy evaluation, and prognosis analysis.Patients and methods: Data were collected by a retrospectively statistical analysisof clinical data of the NHL patients, including clinical data, gender, age, diseaselocation, the first symptom, bone marrow violations and laboratory examination, withthe unambiguous pathological diagnosis from January of2002to December of2012in First Affiliated Hospital of Nanhua University; all NHL cases were derived by thepathological histologically classification using2008year edition of WHOclassification, and the clinical staging using Ann Arbor clinical staging system;standard treatment of NHL patients for more than3cycles chemotherapy; thetherapeutical assessment were valued according to the traditional WHO efficacycriteria (the patients with PET/CT imagological examination to exclude CRu), IPIindex, follow-up data, survival analysis, the elderly patients with DLBCL weredivided into two group accordding to the different therapeutic regimen of R-CHOPand CHOP to evaluated its prognosis.Results:297cases of NHL patients were included in the study; the sex ratio (maleto female) of297cases was1.83:1, with a median age of49.3years, the case ofpatients’ age from30to60years accounting for45.8%cases included in the study, onset age with an unimodal distribution; the Lymph nodes location in the NHLpatients with lymph node onsetting were neck lymph nodes (29.0%), mediastinallymph nodes (21.2%), supraclavicular lymph nodes (13.8%), and inguinal lymphnodes (9.1%); the NHL patients with extranodal lymphoid tissue onset were nasal(16.5%), other place in the Waldeyer’s ring excluding oropharyngeal lymph nodes(10.8%), bone marrow (6.4%), gastric mucosa (5.4%); distribution of local symptoms:neck mass (95cases,32.0%), chest pain and tightness in the chest (19cases,6.4%), abdominal pain (14cases,4.7%), pruritus (12cases,4.0%); the overalltherapeutic efficiency of B-cell lymphoma was73.7%, while the CR and PR were38.4%and35.4%, respectively; the overall therapeutic efficiency of T/NK celllymphoma was40.5%, while the CR and PR were14.3%and26.2%, respectively;the overall efficiency and CR of B cell lymphoma were significantly higher T/NKcell lymphoma group (χ2=7.977，14.131；P=0.005，0.001); the mediate high-risk andhigh-risk group in the DLBCL group was27cases (27/64cases,42.2%), of which inENK/T-NT was21cases (21/32,65.6%), the low or medium risk group in allDLBCL was57.9%; Among141cases with the complete three or more cycles ofchemotherapy in all NHL patients with the median survival of45.0months, and withthe average survival of58.5months,3-yr survival rate was52.9%, and5-yr survivalrate44.3%;8cases of NHL performed PET/CT to exclude CRu, compared thepatients before introduction of PET/CT to the therapeutic efficiency evaluation, CRhad increased from25.0%to37.5%, and PR increasing from12.5%to37.5%;DLBCL patients by IPI prognostic evaluation in the low risk group3-year survivalrate was77.8%, and in high-risk groups59.4%, and overall survival between the twogroups with a significant difference (χ2=3.559, P=0.037); DLBCL patients with anearly Ann Abor clinical stage grouping, the3-year survival rate was83.6%, and inthe late group64.2%, but with no significant difference in overall survival betweenthe two group (χ2=2.869, P=0.09); the elderly patients with DLBCL using CD20(+) grouping,the3year survival rate was78.4%, CD20(-) patients89.2%, with nosignificant difference in overall survival between the two (χ2=1.907, P=0.167); theelderly patients with DLBCL using R-CHOP regimen, the3-year survival rate was 67.7%, CHOP regimen62.7%, and there was no significant difference in overallsurvival between the two (χ2=1.002, P=0.317).Conclusion:1. The top three pathological types of NHL patients in First Affiliated Hospital ofNanhua University are DLBCL-NOS, ENK/T-NT, and MALT.2. The overall therapeutic efficiency of B-cell lymphoma underwent more than3cycles of standard treatmen was51.5%, and that of T/NK lymphoma was33.3%，and5-year survival rate44.3%;3. Introduction of PET/CT imaging in8cases of DLBCL patients to exclude CRuimproves the accuracy of therapeutic efficiency evaluation.