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目的:探讨原发性前列腺恶性淋巴瘤(primary malignant lymphoma of the prostate,PMLP)的临床诊治特征及预后。方法:收集中山大学附属第三医院、中山大学附属第一医院、平顶山学院附属医院2005年11月至2016年12月共11例PMLP患者的临床资料、诊疗及预后信息。结果:11例患者发病年龄57~82岁,中位年龄68岁。血清前列腺特异性抗原(prostate-specific antigen,PSA)平均2.68ng/ml(0.54~4.82ng/ml),血清乳酸脱氢酶(LDH)平均值为314.9(123~560)U/L。CT检查均提示前列腺明显增大,临床下尿路梗阻症状明显。组织病理学符合B细胞源性非霍奇金淋巴瘤,其中弥漫大B淋巴瘤9例,套细胞淋巴瘤2例。中位生存期28个月(9~62月),6例已死亡。10例选择手术治疗,6例术后进一步接受CHOP或R-CHOP化疗,其中3例生存期已超过56个月。结论:PMLP罕见,预后与病理组织学分类、临床分期及治疗方案紧密相关。实验室检查(PSA、LDH)、CT检查特异性不明显。PMLP化疗效果明显,手术可有效缓解下尿路梗阻症状,必要时可联合治疗。
Objective: To investigate the clinical characteristics and prognosis of primary malignant lymphoma of the prostate (PMLP). Methods: The clinical data, diagnosis and prognosis information of 11 PMLP patients were collected from the Third Affiliated Hospital of Sun Yat-sen University, the First Affiliated Hospital of Sun Yat-sen University and the Affiliated Hospital of Pingdingshan University from November 2005 to December 2016. Results: The onset age of 11 patients was 57-82 years old, with a median age of 68 years. The average value of serum PSA was 2.68ng / ml (0.54 ~ 4.82ng / ml) and the average LDH was 314.9 (123 ~ 560) U / L. CT examination showed a significant increase in prostate, clinical symptoms of urinary tract obstruction was obvious. Histopathology is consistent with B cell-derived non-Hodgkin’s lymphoma, including diffuse large B lymphoma in 9 cases, mantle cell lymphoma in 2 cases. The median survival was 28 months (9 to 62 months) and 6 deaths. Ten patients underwent surgery. Six patients underwent CHOP or R-CHOP after surgery. Survival of the three patients was over 56 months. Conclusion: PMLP is rare, prognosis and histopathological classification, clinical stage and treatment programs are closely related. Laboratory tests (PSA, LDH), CT examination specificity is not obvious. PMLP chemotherapy is obvious, surgery can effectively alleviate the symptoms of lower urinary tract obstruction, if necessary, can be combined treatment.