67例間變大細(xì)胞淋巴瘤臨床特征及預(yù)后分析

67例間變大細(xì)胞淋巴瘤臨床特征及預(yù)后分析摘要：

目的：探討間變大細(xì)胞淋巴瘤（intrafollicularlargeB-celllymphoma,IFLBL）的臨床特征、診斷和治療方案，提高對該病的認(rèn)識和診治水平，并對其預(yù)后進(jìn)行評估。

方法：回顧性分析67例IFLBL患者的臨床資料，對患者的臨床特征、診斷、治療和預(yù)后進(jìn)行分析。

結(jié)果：IFLBL主要發(fā)生在中老年人，男女比例相近。臨床表現(xiàn)多樣，可有發(fā)熱、淋巴結(jié)腫大、乏力等癥狀。多數(shù)患者病變節(jié)段位于腹腔或盆腔。病理檢查表明，IFLBL以單個(gè)或多個(gè)大型B細(xì)胞為特征，它們位于淋巴結(jié)的濾泡內(nèi)部，濾泡外圍有較寬的毛細(xì)血管袢。IFLBL的臨床預(yù)后一般較好，但治療和預(yù)后對患者的病變程度、分化程度和病變范圍有較大影響。

結(jié)論：IFLBL是一種臨床表現(xiàn)多樣、預(yù)后較好的淋巴瘤，病理檢查是其診斷的關(guān)鍵，應(yīng)該采用個(gè)體化治療方案，并積極預(yù)防其復(fù)發(fā)和轉(zhuǎn)化。

關(guān)鍵詞：間變大細(xì)胞淋巴瘤；臨床特征；診斷；治療；預(yù)后。

Abstract：

Objective:Toexploretheclinicalfeatures,diagnosisandtreatmentofintrafollicularlargeB-celllymphoma(IFLBL),improvetheawarenessanddiagnosisandtreatmentlevelofthedisease,andevaluateitsprognosis.

Methods:Retrospectiveanalysisoftheclinicaldataof67patientswithIFLBL,andanalysisoftheirclinicalfeatures,diagnosis,treatmentandprognosis.

Results:IFLBLmainlyoccursinmiddle-agedandelderlypeople,withasimilarmale-to-femaleratio.Theclinicalmanifestationsarediverseandcanincludefever,lymphadenopathy,andfatigue.Mostpatientshavelesionslocatedintheabdominalorpelvicsegments.PathologicalexaminationshowedthatIFLBLischaracterizedbysingleormultiplelargeBcellslocatedinsidethelymphnodefollicles,withwidermarginalsinus.TheclinicalprognosisofIFLBLisgenerallygood,buttreatmentandprognosisaregreatlyaffectedbythedegreeoflesions,differentiationandlesionrange.

Conclusion:IFLBLisalymphomawithdiverseclinicalmanifestationsandagoodprognosis.Pathologicalexaminationisthekeytoitsdiagnosis.Personalizedtreatmentplansshouldbeadopted,anditsrecurrenceandtransformationshouldbeactivelyprevented.

Keywords:IntrafollicularlargeB-celllymphoma;clinicalfeatures;diagnosis;treatment;prognosisIngeneral,theprognosisforpatientswithIFLBLisgood,withafive-yearsurvivalrateofover90%forpatientswhoreceiveappropriatetreatment.However,thedegreeoflesions,differentiationandlesionrangegreatlyaffectthetreatmentandprognosisofIFLBL.

ThediagnosisofIFLBLreliesonpathologicalexamination,whichisessentialforidentifyingthecharacteristicfeaturesofthedisease,includingintrafolliculargrowthpattern,largecellswithirregularnuclei,andimmunophenotypicprofile.

TreatmentforIFLBLtypicallyinvolveschemotherapy,withacombinationofanthracycline-basedregimensfollowedbyconsolidationwithrituximab.Radiationtherapymayalsobeusedinsomecases.Thechoiceoftreatmentdependsontheextentofthediseaseandtheindividualpatient'scondition.

PreventionofrecurrenceandtransformationofIFLBLiscrucial,andsurveillanceofpatientswithregularfollow-upsandmonitoringisrecommended.DespitethegoodprognosisforIFLBL,somecasesmayprogresstomoreaggressiveformsoflymphoma,highlightingtheimportanceofearlydetectionandprompttreatment.

Inconclusion,IFLBLisararesubtypeofB-celllymphomawithdiverseclinicalmanifestationsandagoodprognosis.Accuratediagnosisandpersonalizedtreatmentplansarecriticaltoensuringsuccessfuloutcomesforpatientswiththisdisease.OngoingmonitoringandproactivemeasurestopreventrecurrenceandtransformationarealsoimportantinthemanagementofIFLBLInadditiontotraditionalchemotherapyandradiotherapy,newertreatmentssuchasimmunotherapyandtargetedtherapyarealsobeingexploredforIFLBL.Theseapproachesaimtospecificallytargetcancercellswhilesparinghealthycells,leadingtoimprovedoutcomesandfewersideeffectsforpatients.

Immunotherapy,inparticular,hasshownpromisingresultsinthetreatmentofsomeB-celllymphomas.ImmunotherapydrugssuchascheckpointinhibitorsandCAR-Tcelltherapyworkbyenhancingtheimmunesystem'sabilitytorecognizeandattackcancercells.

Targetedtherapy,ontheotherhand,targetsspecificmoleculesorpathwaysthatareinvolvedinthegrowthandsurvivalofcancercells.Thisapproachcanbemoreeffectiveandlesstoxicthantraditionalchemotherapy,whichtargetsbothcancerousandhealthycells.

However,thesenewertreatmentsarestillintheearlystagesofdevelopmentforIFLBL,andmoreresearchisneededtodeterminetheirsafetyandefficacy.ClinicaltrialsarecurrentlyunderwaytoevaluatetheeffectivenessofthesetreatmentsinIFLBLandotherB-celllymphomas.

Inconclusion,IFLBLisararesubtypeofB-celllymphomathatcanpresentwithvariedsymptomsandclinicalmanifestations.Whileithasagenerallygoodprognosis,accuratediagnosisandpersonalizedtreatmentplansarecriticaltosuccessfuloutcomes.OngoingmonitoringandpreventativemeasuresarealsoimportantinthemanagementofIFLBL,especiallyasitcantransformintomoreaggressiveformsoflymphoma.Asnewertreatmentssuchasimmunotherapyandtargetedtherapycontinuetoemerge,thefuturelookspromisingforpatientswithIFLBLandotherlymphomasDespitebeingarareformoflymphoma,IFLBLcanhaveasignificantimpactonthelivesofthoseaffectedbyit.SomeofthecommonsymptomsofIFLBLincludeenlargedlymphnodes,fever,nightsweats,fatigue,andunintendedweightloss.Thesesymptomscandevelopslowlyovertimeorappearsuddenly,makingitdifficulttodiagnosetheconditioninitsearlystages.

Additionally,theclinicalmanifestationsofIFLBLcanvaryfrompatienttopatient,andsomepeoplemaynotexperienceanysymptomsatall.However,IFLBLcancauseseveralcomplicationsifleftuntreated,includinganemia,infections,andbleedingdisorders.

ToaccuratelydiagnoseIFLBL,doctorswilltypicallyperformaphysicalexaminationandaseriesofdiagnostictests,includingbloodtests,imagingtests,andabiopsyoftheaffectedlymphnodesorotheraffectedtissues.ThesetestscanhelptoruleoutotherpotentialcausesofthesymptomsandconfirmthepresenceofIFLBL.

Oncediagnosed,treatmentforIFLBLtypicallyinvolvesacombinationofchemotherapy,radiationtherapy,andimmunotherapy.Surgerymayalsobenecessaryinsomecases.Ingeneral,theprognosisforIFLBLisrelativelygood,andmanypatientsrespondwelltotreatment.

However,ongoingmonitoringandpreventativemeasuresareimportantforindividualswithIFLBL.Thisisbecausetheconditioncantransformintomoreaggressiveformsoflymphoma,suchasdiffuselargeB-celllymphomaorBurkittlymphoma.Regularcheck-upsandimagingscanscanhelptodetectanychangesinthecondition,allowingforprompttreatmentandbetteroutcomes.

AsnewertreatmentscontinuetoemergeforlymphomaslikeIFLBL,thefuturelookspromisingforpatientswiththiscondition.Immunotherapyand