| Objective:To explore the clinical features,pathological types,treatment and prognostic factors of lymphoma patients with mediastinal mass.Method:We retrospectively analyzed the clinical data of 60 lymphoma patients with mediastinal mass from January 2009 to December 2014 at the First Affiliated Hospital of Jilin University.The clinical symptoms,pathologic type,treatment and prognosis of these patients were analyzed.To explore the clinical characteristics,survival and prognosis of patients with mediastinal lymphoma.Result:The patients accounted for 7.5%(60/800)of the initial diagnosis of lymphoma patients patduring the same period,and accounted for 9.7%(60/620)of the mediastinal tumors during the same period.Male patients accounting for the majority,and the ratio of male to female is 1.5: 1.Less than or equal to 60 years old is accounted for 90.00%(54/60),and the median age of onset was 32 years old(from 8 to 83 years).Approximately30% of patients were diagnosed with superior vena cava compressionsyndrome,and clinical stage III-IV disease is accounted for 63.33%(38/60).16 cases of HL patients,accounting for 26.67% of the total(16/60),and 44 cases of NHL patients,accounting for 73.33% of the total(44/60).IPI score 0-2 points accounted for 73.33%(44/60),and ? 3points accounted for 26.67%(16/60).ESR,lactate dehydrogenase,and?2 microglobulin increased in patients accounted for 65.00%,60.00%,and 76.67%.The lymphoma occurred in the anterior mediastinum,accounting for 93.33%.In 56 cases of patients with regular treatment,follow-up deadline of2016 May,5 cases were lost,51 cases were followed up,and the median survival time were 46 months,with 46 months of the median follow-up time.The treatment was effective in 32 cases,accounting for 55.36%.The efficiency of HL(68.75%)was higher than that of NHL(50%).The effective rates of LBCL and T-LBL were 70.00% and 33.33%.The median survival time of HL patients did not meet,while that of NHL pateints was42 months,with a statistically significant difference(P = 0.033).The median survival time of patients with LBCL and T-LBL was 49 months and 29 months,with Statistical differences(P = 0.033).Univariate prognostic analysis showed that IPI score(P = 0.010)and pathological type of T-LBL(P = 0.009)were factors related to prognosis,and the difference was statistically significant.Sex,age,Ann Arbor staging,B symptoms,erythrocyte sedimentation rate,LDH,?2 microglobulin,andso on,have no effect on survival.Multivariate analysis showed that IPI score and pathological type were not independent prognostic factors.Conclusion:1.The patients accounted for 7.5%(60/800)of the initial diagnosis of lymphoma during the same period,with mediastinal mass most often in the anterior mediastinum.2.Lymphoma patients with mediastinal mass occurs in the young middle age,more men than women,diagnosed in the late disease for the first time(clinical stage III-IV disease is accounted for 63.33%).3.The pathologic types of the lymphoma were mainly large B-cell lymphoma(33.33%),T-lymphoblastic lymphoma(31.67%)and Hodgkin's lymphoma(26.67%).4.The survival time of lymphoma patients with mediastinal mass was significantly correlated with the pathological type,and the prognosis of Hodgkin's lymphoma patients is the best;The survival time of patients with Hodgkin's lymphoma was significantly better than that of non-Hodgkin's lymphoma.In non-Hodgkin's lymphoma,the large B-cell lymphomas' survival time is better than the T lymphoblastic lymphomas'.5.Univariate analysis showed that IPI score and pathological type were related to prognosis,and prognosis of T lymphoblastic lymphoma is the worst.Multivariate analysis showed that IPI score and pathological type were not independent prognostic factors.Sex,age,Ann Arbor staging,B symptoms,erythrocytesedimentation,Lactatedehydrogenase,and ?2microglobulin were not prognostic factors. |
PDF Full Text Request