NK细胞淋巴瘤_白血病病理特点和预后研究.pdf

第18卷第3期中国现代医学杂志Vol.18No.3
2008年2月ChinaJournalofModernMedicineFeb.2008

文章编号:1005-8982(2008)03-0358-03

NK细胞淋巴瘤/白血病病理特点和预后研究

莫祥兰1,2,苏祖兰1,冯智英1,孙碧红2,孔祥元1
(1.中山大学附属第三医院病理科,广东广州510630;
2.广西省人民医院血液科,广西南宁530021)

摘要:目的探讨NK细胞淋巴瘤/白血病病理特点及影响预后因素。方法对38例NK细胞淋巴瘤/
白血病临床病理资料进行回顾性分析,统计临床病理参数对生存期的影响。结果肿瘤细胞形态多样,易侵犯
血管伴微血管透明血栓形成,嗜上皮反应;所有病例肿瘤细胞强表达CD56、TIA-1、GranzymeB,7.9%(3/38)
表达CD8,94.6%(36/38)EBER阳性;Kaplan-Meier单因素分析显示:B症状、临床分期为III-IV、乳酸脱氢酶
升高、血AST升高、外周血三少、区域淋巴结累及和未治或单一治疗方式是预后差的因素,IPI分组与生存期无
明显相关性。结论NK细胞淋巴瘤/白血病形态学变异大,有亲血管和上皮倾向;预后与治疗方式有关,两种
以上方法联合治疗可能为治疗NK细胞淋巴瘤/白血病较好方法;IPI不是判断其预后的好工具。
关键词:NK细胞肿瘤;病理特点;预后
中图分类号:R733.7文献标识码:B

Pathologicalfeaturesandprognosisofnaturalkillercell
lymphomaandleukemia

MOXiang-lan1,2,SUZu-lan1,FENGZhi-ying1,SUNBi-hong2,KONGXiang-yuan1
(1.DepartmentofPathology,theThirdAffiliatedHospitalofSunYatSenUniversity,Guangzhou,
Guangdong510630,P.R.China;2.DepartmentofPathology,People′sHospitalofGuangxiProvince,
Nanning,Guangxi530021,P.R.China)

Abstract:【Objectives】Toinvestigatepathologicalandprognosticfactorsinpatientswithnaturalkillercelllym-
phomaandleukemia(NKL).【Methods】Theclinicopathologicaldataof38patientswhowerediagnosedwithNKL
wereretrospectivelystudied.Therelationshipbetweenpatients′clinicopathologicalfeaturesandprognosiswereana-
lyzedinKaplan-Meiermethod.【Results】Histopathologically,inmostofthecases,thetumorcellsweremedium
sizewithvascularandepitheliuminvasion.Ofthe38cases,thetumorcellswerepositivetoCD56,TIA-1and
GranzymeB,7.89%ofthemwereCD8expression,94.6%werepositivetoEBER.Kaplan-Meieranalysisshowedthat
thepatients,whohadBsymptoms,highlevelASTandLDH,pancytopenia,stageIII/IV,regionallymph-nodein-
volvementandwithouttreatmentorwithsingletherapystrategyhadpooreroutcome.【Conclusions】MostofNKcell
lymphomaareENKL,thetumorcelltendtoinvadevascularandepithelium.IPIisnotthebestprognostictoolfor
NKL.
Keywords:NKcellneoplasm;pathologicalfeatures;prognosis

NK细胞淋巴瘤/白血病(naturalkillercell发于亚洲及美洲中部和南部,青壮年多见,病程进展
lymphomaandleukemia,NKL)包括侵袭性NK细胞快,疗效差,预后差。目前,对NKL的临床病理特点