Objective: To explore the clinical characteristics, the best treatment and prognostic factors of primary pulmonary NK/T-cell lymphoma. Methods: A total of 24 cases with primary pulmonary NK/T-cell lymphoma from April 2011 to May 2019 were analyzed retrospectively. Survival analysis was performed using the Kaplan-Meier method and groups were compared using the log-rank test. Multivariate analysis using Cox proportional hazard regression model was conducted to confirm independent prognostic factors for overall survival (OS) and progression-free survival (PFS) . Results: ①The cohort of 24 patients included 16 male and 8 female with a median age of 49 years (range, 4-76 years) old. ②Most patients initially presented with a fever (66.7%) , cough and dyspnea. Chest imaging manifestations were primarily unilateral (45.8%) or bilateral (54.2%) pulmonary consolidation, nodules or mass. ③20 patients received chemotherapy, radiotherapy or hematopoietic stem cell transplantation, the rest 4 cases palliative treatment. Median OS was 9.5 months (range, 0.1-26.0 months) . The estimated 1-year OS rate was 45.8%. Overall response rate of patients treated with asparaginase-based regimen was 88.2%. ④In univariate survival analysis, age≤60 was prognostic for longer OS and PFS, compared with age>60 (P=0.002 and 0.004, respectively) ; ECOG≤2 was prognostic for longer OS and PFS, compared with ECOG>2 (P=0.042 and 0.004, respectively) . In multivariate survival analysis, age>60 and ECOG>2 were significantly correlated with inferior OS and PFS (OS: P=0.024 and 0.024, respectively; PFS: P=0.035 and 0.024, respectively) . Conclusions: Primary pulmonary NK/T-cell lymphoma was a rare disease with poor prognosis. Asparaginase-based regimens appeared to be effective. Age and ECOG served as independent prognostic factors for primary pulmonary NK/T-cell lymphoma patients.
目的： 探讨原发性肺NK/T细胞淋巴瘤的临床特点、最佳治疗方案及预后因素，以提高对原发性肺NK/T细胞淋巴瘤的认识。 方法： 回顾性分析2011年4月至2019年5月收治的24例明确诊断为原发性肺NK/T细胞淋巴瘤患者的临床资料，并对其临床特征、治疗及预后进行分析。采用Kaplan-Meier进行生存分析，应用Cox比例风险回归模型确定影响总生存（OS）期和疾病无进展生存（PFS）期的预后因素。 结果： ①入组的24例患者中男16例，女8例，中位年龄为49（4~76）岁。②患者初始症状大多为发热（66.7%）、咳嗽、呼吸困难。主要的胸部影像学表现为单侧（45.8%）或双侧（54.2%）肺部浸润、结节或肿块。③24例患者中20例接受放化疗或造血干细胞移植，4例接受姑息治疗。所有患者的中位OS期为9.5（0.1~26.0）个月，1年OS率为45.8%。以门冬酰胺酶为基础化疗方案的总有效率（ORR）为88.2%。④单因素分析显示，年龄≤60岁患者的OS和PFS显著优于年龄>60岁的患者（P值分别为0.002、0.004），美国东部肿瘤协作组体能状态评分（ECOG评分）≤2分患者的OS和PFS显著优于ECOG评分>2分患者（P值分别为0.042、0.004）。多因素分析显示，年龄>60岁和ECOG评分>2分与不良OS和PFS相关（OS：P值分别为0.024、0.024；PFS：P值分别为0.035、0.024）。 结论： 原发性肺NK/T细胞淋巴瘤罕见且预后差，以门冬酰胺酶为基础的化疗方案疗效显著，年龄>60岁和ECOG评分>2分是患者独立的不良预后因素。.
Keywords: NK/T-cell lymphoma; Primary pulmonary lymphoma; Prognosis.