| Background Extranodal NK/T-cell lymphoma(ENKTL)is a relatively rare type of Non Hodgkin's lymphoma.ENKTL has a special morphology and immune phenotype and highly invasive.The more common invaded parts are the patient's nasal sinuses,nasal and pharyngeal etc.A small number of studies have been found that in the skin,gastrointestinal tract,testis and other external organs are also subject to a certain degree of invasion.Because it is a kind of highly malignant tumor,the progress is rapid and the prognosis is bad.In recent years,with the in-depth study of the disease,it was found that many patients with extranodal NK/T were infected with EB virus,and many patients were accompanied by unexplained splenomegaly.At present,there are some reports that EB is closely related to extranodal NK/T cell lymphoma,and splenomegaly is closely related to the prognosis of NK/T cell lymphoma.In recent years,there is no report about the influence of spleen enlargement on the prognosis of NK/T cell lymphoma.This study through the CT or PET-CT to observe the spleen,in order to further study the effect of spleen enlargement on the therapeutic effect and prognosis.Objective In order to study the therapeutic effect and prognosis of spleen enlargement on the treatment of extranodal NK/T cell lymphoma,this research through the CT or PET-CT change was observed before and after treatment of spleen,discusses further study the effect of spleen enlargement on the therapeutic effect and prognosis.Methods From the first affiliated hospital of zhengzhou university from march 2011 to september 2016 during diagnosed stage III-IV patients with extranodal NK/T cell lymphoma in 50 cases,according to the situation of splenomegaly before treatment,divided into the normal spleen group and the splenomegaly group,and evaluate the influence of splenomegaly on treatment efficacy and prognosis.Results 1.Splenic enlargement in extranodal NK/T cell lymphoma:In 50 cases of extranodal NK/T cell lymphoma patients,21 cases of patients with splenomegaly,29 patients with normal spleen,spleen goiter rate was 42%(21/50).2.Analysis of cases of extranodal NK/T cell lymphoma:50 cases of extranodal NK/T cell lymphoma in patients with splenomegaly in 12 cases of group IV patients(57.1%,12/21)was significantly higher than that in the group without spleen enlargement in 12 cases of IV patients(41.4%,12/29)(P<0.05);21 cases of spleen the enlarged group was accompanied by B symptoms of the 13 cases(61.9%,13/21),was significantly higher than that of 11 cases of splenic enlargement without group(37.9%,11/29)(P<0.05);50 cases of extranodal NK/T cell lymphoma patients,EBV was positive in 24 cases,the total infection rate of EBV was 48%(24/50),the splenomegaly group with EBV infection in 16 patients(76.2%,16/21),was significantly higher than that of splenic non splenomegaly group 8 patients(27.6%,8/29)(P<0.05).3.The relationship between spleen enlargement and short-term efficacy in patients with extranodal NK/T cell lymphoma:In 50 cases of extranodal NK/T cell lymphoma patients,Objective response rate and disease control rate were respectively 42.9%(9/21)and 61.9%(13/21)in the patients with splenomegaly.Objective response rate and disease control rate were respectively 62.1%(18/29)and 79.3%(23/29)in the patients with normal spleen.The objective response rate of the two groups was significantly different(P<0.05),and the disease control rate was not statistically significant(P>0.05).4.The relationship between efficacy and safety of spleen changes after treatment: 21 cases of splenic enlargement in patients after standard treatment in patients with spleen reduced objective response rate and disease control rate were 61.5%(8/13)and 69.2%(9/13),by law after treatment,reduce the patient's spleen was not the objective response rate and disease control rate were 25%(2/8)and 50%(4/8),compare the two objective response rate have obvious difference(P<0.05),and the disease control rate had no significant difference(P>0.05).5.The relationship between the long-term curative effect of splenomegaly and extranodal NK/T cell lymphoma patients:due to the limited number of patients in this study,among 50 ENKTL patients,3 cases died.In the splenomegaly group,the 2-and 3-year PFS was 72.1% and 47.2%.In the normal spleen group,the 2-,3-and 5-year PFS was 79.3%,66.1% and 49.6%,respectively.No statistical significance was noted in 2-and 3-year PFS between two groups(P>0.05);In the splenomegaly group,the 2-and 3-year OS was 77.6% and 58.2%.In the normal spleen group,the 2-,3-and 5-year OS was 90.7%,79.3% and 59.5%,respectively.No statistical significance was noted in 2-and 3-year OS between two groups(P>0.05).6.The relationship between the change and the long-term curative effect of spleen after treatment:21 cases of splenomegaly in 13 patients(61.9%)patients after standard treatment of spleen with varying degrees of narrowing,patients with splenomegaly group after treatment reduced spleen and spleen did not reduce the patient's 2 years of PFS were 75.2% and 45%,two had significant the difference(P<0.05),2 OS were 84.6% and 58.3%,a significant difference between the two groups(P<0.05).Conclusion In extranodal NK/T cell lymphoma,clinical factors of splenomegaly with the level of staging?EBV infection and B related symptoms,and spleen size before and after treatment and the changes of the short-term and long-term effect,suggesting that splenomegaly and splenic changes after treatment is expected to become an important indicator of the prognosis evaluation of extranodal NK/T cell lymphoma patients. |
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