Objective: To compare clinical characteristics and prognosis between patients with primary (PTL) and secondary thyroid lymphoma (STL) . Methods: A retrospective analysis was performed on 46 patients with thyroid lymphoma (PTL 19, STL 27) from January 2002 to October 2018. Results: ①PTL group included 4 males and 15 females, with a median age of 57 years. The STL group included 10 males and 17 females, with a median age of 61 years. Diffuse large B-cell lymphoma (DLBCL) was the main pathological subtype in both PTL and STL groups, with 14 cases (73.7%) and 20 cases (74.1%) respectively. In terms of clinical manifestations, goiter was the most common symptom in PTL patients 100.0% (19/19) , while 29.6% (8/27) STL had goiter (P<0.001) . The incidences of increased thyroglobulin antibody (TRAb) /thyroid peroxidase antibody (TPO) were 81.3% (13/16) in PTL group and 43.8% (7/16) in STL group (P=0.028) respectively. Concerning the clinical features of patients, only two PTL patients (10.5%) with advanced Ann Arbor stage (Ⅲ/Ⅳ) , while 21 (77.8%) STL experienced advanced Ann Arbor stage (P<0.001) . Elevated serum β(2)-MG were appeared in 1 (7.1%) PTL and 9 (47.4%) STL patients (P=0.013) , and advanced IPI score (3-5) was more common in STL than PTL (59.3% vs 5.3%, P<0.001) . ②Among the 17 PTL patients who received treatments, 15 (88.2%) achieved remission; as for STL patients received treatments, 23/25 (92.0%) were in remission. The 5-year overall survival (OS) rates of PTL (n=17) and STL groups (n=25) were (87.4±8.4) % and (70.0±13.1) % (P=0.433) respectively. ③The 5-year OS rate in 41 patients with B-cell thyroid lymphoma was (81.1±7.5) %. Univariate analysis showed that IPI score of 3-5 (P=0.040) and high level of serum IL-8 (P=0.022) were significantly associated with poor outcome. Conclusion: DLBCL was the most common subtype in both PTL and STL, and goiter was the major symptom in PTL. IPI score of 3-5 and high level of serum IL-8 were unfavorable prognostic factors for patients with B-cell thyroid lymphoma.
目的： 比较原发甲状腺淋巴瘤（PTL）、继发甲状腺淋巴瘤（STL）的临床特征和疗效。 方法： 回顾性分析2002年1月至2018年10月收治的46例甲状腺淋巴瘤患者（PTL 19例，STL 27例）的病例资料。 结果： ①PTL组男4例，女15例，中位发病年龄57（28~82）岁；STL组男10例，女17例，中位年龄61（32~83）岁；PTL、STL组均以弥漫大B细胞淋巴瘤（DLBCL）为主要病理亚型，分别为14例（73.7%）、20例（74.1%）；甲状腺肿大在PTL组、STL组的发生率分别为100.0%（19/19）、29.6%（8/27）（P<0.001）；甲状腺球蛋白抗体（TRAb）/甲状腺过氧化物酶抗体（TPO）升高在PTL组、STL组的发生率分别为81.3%（13/16）、43.8%（7/16）（P=0.028）；PTL组、STL组Ann Arbor分期Ⅲ/Ⅳ期患者分别为2例（10.5%）、21例（77.8%）（P<0.001），血β(2)微球蛋白升高患者分别为1例（7.1%）、9例（47.4%）（P=0.013），IPI评分3~5分患者分别为1例（5.3%）、16例（59.3%）（P<0.001）。②17例PTL患者接受治疗，15例（88.2%）获得缓解；25例STL患者接受治疗，23例（92.0%）获得缓解。③PTL组（17例）、STL组（25例）5年总生存（OS）率分别为（87.4±8.4）%、（70.0±13.1）%（P=0.433）。④B细胞甲状腺淋巴瘤患者（41例）的5年OS率为（81.1±7.5）%，IPI评分3~5分、血清IL-8升高对B细胞甲状腺淋巴瘤患者5年OS率有影响（P=0.040，P=0.022）。 结论： PTL和STL均以DLBCL为主要病理亚型，甲状腺肿大在PTL中更多见。IPI评分3~5分、血清IL-8升高为B细胞甲状腺淋巴瘤的不良预后因素。.
Keywords: Disease attribute; Lymphoma, non-Hodgkin; Prognosis; Thyroid neoplasms.