| Objective: To retrospectively analyze and summarize the clinical characteristics of extranodal NK/T cell lymphoma,explore the prognostic factors that may be related to the disease,accumulate data for diagnosis,treatment and prognosis evaluation of this disease,and improve clinical guidance.Methods: In this study,the clinical data(sex,age,nationality,serum LDH,anemia,BMI index,B symptom,treatment mode,Ann Arbor clinical stage,ECOG score,IPI score)of 27 patients with extranodal NK/T cell lymphoma diagnosed by pathology and immunohistochemistry in the affiliated Hospital of Youjiang Medical College for nationalities from September 2013 to September 2019 were analyzed retrospectively.The clinical characteristics,survival and factors affecting long-term survival were analyzed by SPSS23.0 statistical software.Results:(1)Among the 27 patients,10 were female(37.0%),17 were male(63%),the ratio of male to female was 1.7:1,the age of onset was 13 ～ 76 years old,the median age of onset was 44 years old,the primary site was nasal cavity in19 cases(70.4%),followed by pharynx in 6 cases(22.2%),subcutaneous in 1 case(3.7%)and ileocecum in 1 case(3.7%).Nasal congestion was common in patients with primary nasal cavity for the first time,accounting for 10 cases(52.6%),followed by purulent nose in 6 cases(31.6%)and bloody nose in 3 cases(15.8%).The first manifestation was fever,abdominal pain and diarrhea in the subcutaneous part and ileocecal part.17 patients(63.0%)had B symptoms,and 10patients(37.0%)had no B symptoms at the first visit.According to the Ann Arbor clinical staging standard,II stage was the most common in 27 patients,accounting for 14 cases(51.9%),followed by stage I in 8 cases(29.6%),IV stage in 3 cases,11.1%),III stage in 2 cases(7.4%).According to the ECOG physical fitness scoring standard,24 cases(88.9%)with an ECOG score <2 points,and 3 cases(11.1%)with an ECOG score ≥ 2 points.According to the IPI risk factor score,22cases(81.5%)with an IPI score between 0 and 2 points,and 5 cases(18.5%)with an IPI score between 3-5 points.Among the 27 patients,laboratory test results showed that 18 cases(66.7%)had elevated serum LDH levels,and 9 cases(33.3%)had normal serum LDH levels.11 cases(40.7%)were anemia,and 16 cases(59.3%)were without anemia.BMI index <20 accounted for 12 cases(44.4%),and BMI index ≥ 20 accounted for 15 cases(55.6%).(2)Analysis of the prognosis of ENKL patients: The follow-up period ended on January 14,2021.13 survived(48.1%)and 14 died(51.9%)in this study of the 27 patients with ENKL.Univariate analysis showed that symptoms B,serum LDH level,treatment regimen,Ann Abor stage,ECOG score and IPI score were related to the long-term survival of the disease,but multivariate analysis showed that symptom B,serum LDH level,treatment regimen,Ann Abor stage,ECOG score and IPI score were not independent factors affecting the survival rate of the disease.Conclusion:(1)ENKL often occurs in middle-aged people,especially in males.The course of disease is often in II stage at the first diagnosis,often accompanied by B symptoms and elevated serum LDH;the primary site is often seen in the nasal cavity,but the clinical manifestations are often atypical and non-specific.(2)the 1-,2-and 3-year overall survival rates of 27 patients with extranodal NK/T cell lymphoma were 74.1%,66.7% and 51.8%,respectively.Univariate analysis showed that the long-term survival rates of ENKL patients with B symptoms,elevated serum LDH,chemotherapy alone,clinical stage III-IV,ECOG score ≥ 2 and IPI score between 3 and 5 were significantly worse.The results of multivariate analysis showed that the occurrence of B symptoms,the increase of serum LDH level,the choice of different treatment modes,different Ann Arbor stages,ECOG score and IPI score were not independent risk factors affecting the survival rate of patients with this disease. |
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