1\u3001\u75be\u75c5\u6982\u5ff5\u3001\u75c5\u56e0<\/p>\n
\u2014<\/p>\n
\u6076\u6027\u6dcb\u5df4\u7624\u5206\u4e3a\u7ed3\u5185\u6dcb\u5df4\u7624\u548c\u7ed3\u5916\u6dcb\u5df4\u7624\u300230% \u81f3 40% \u7684\u7ed3\u5916\u6dcb\u5df4\u7624\u8d77\u6e90\u4e8e\u80c3\u80a0\u9053\u3002MALT\u6dcb\u5df4\u7624\u548c\u5f25\u6f2b\u6027\u5927B\u7ec6\u80de\u6dcb\u5df4\u7624\uff08DLBCL\uff09\u5728\u80c3\u80a0\u9053\u6dcb\u5df4\u7624\u4e2d\u5e38\u89c1\uff0c\u6ee4\u6ce1\u6027\u6dcb\u5df4\u7624\u5728\u5c0f\u80a0\u4e2d\u76f8\u5bf9\u5e38\u89c1\u3002<\/p>\n
\u5e7d\u95e8\u87ba\u6746\u83cc\u662f\u80c3MALT\u6dcb\u5df4\u7624\u7684\u4e3b\u8981\u75c5\u56e0\uff0c\u4e5f\u4e0e\u90e8\u5206\u80c3DLBCL\u7684\u53d1\u751f\u6709\u5173\u3002\u6b64\u5916\uff0c\u4e00\u4e9b\u80a0\u9053 MALT \u6dcb\u5df4\u7624\u4e5f\u4e0e\u5e7d\u95e8\u87ba\u6746\u83cc\u6709\u5173\u3002\u636e\u62a5\u9053\uff0c\u7a7a\u80a0\u5f2f\u66f2\u83cc\u4e0e\u514d\u75ab\u589e\u751f\u6027\u5c0f\u80a0\u75be\u75c5 (IPSID) \u6709\u5173\uff0c\u540e\u8005\u662f MALT \u6dcb\u5df4\u7624\u7684\u4e00\u79cd\u4e9a\u578b\u3002\u5df2\u77e5\u4eba\u7c7b T \u7ec6\u80de\u767d\u8840\u75c5\u75c5\u6bd2 (HTLV-1) \u611f\u67d3\u4e0e\u6210\u4eba T \u7ec6\u80de\u767d\u8840\u75c5\/\u6dcb\u5df4\u7624\u6709\u5173\uff0c\u5e76\u4e14\u5df2\u77e5\u5148\u524d\u7684\u4e73\u7cdc\u6cfb\u4e0e\u80a0\u75c5\u76f8\u5173\u7684 T \u7ec6\u80de\u6dcb\u5df4\u7624\uff08\u4ee5\u524d\u79f0\u4e3a I \u578b\uff09\u6709\u5173\u3002<\/p>\n
2\u3001\u6d41\u884c\u75c5\u5b66<\/p>\n
\u2014<\/p>\n
\u80c3\u80a0\u9053\u6dcb\u5df4\u7624\u5360\u539f\u53d1\u6027\u6d88\u5316\u9053\u6076\u6027\u80bf\u7624\u76841%\uff5e8%\uff0c\u5360\u975e\u970d\u5947\u91d1\u6dcb\u5df4\u7624\u76845%\uff5e20%\uff0c\u5360\u7ed3\u5916\u6dcb\u5df4\u7624\u768430%\uff5e40%\u3002\u6700\u5e38\u89c1\u7684\u539f\u53d1\u90e8\u4f4d\u662f\u80c3 (60-70%)\uff0c\u5176\u6b21\u662f\u5c0f\u80a0 (20-30%)\u3001\u5927\u80a0 (5-15%)\uff0c\u98df\u9053\u5f88\u5c11 (<1%)\u3002\u5b83\u901a\u5e38\u662f\u591a\u53d1\u6027\u7684\uff0c5% \u5230 10% \u7684\u75c5\u4f8b\u540c\u65f6\u7d2f\u53ca\u80c3\u548c\u80a0\u3002\u6240\u6709\u5e74\u9f84\u6bb5\u90fd\u6709\u53d1\u751f\uff0c\u4ece\u513f\u7ae5\u5230\u8001\u4eba\uff0c\u53d1\u75c5\u9ad8\u5cf0\u5e74\u9f84\u5728 50 \u81f3 60 \u5c81\u4e4b\u95f4\u3002\u80c3\u6dcb\u5df4\u7624\u6ca1\u6709\u6027\u522b\u5dee\u5f02\uff0c\u4f46\u80a0\u9053\u6dcb\u5df4\u7624\u4ee5\u7537\u6027\u4e3a\u4e3b\uff0c\u6bd4\u4f8b\u4e3a2:1\u3002<\/p>\n
\u75c5\u7406\u7ec4\u7ec7\u5b66\u4e0a\uff0c90%\u7684\u6d88\u5316\u9053\u6dcb\u5df4\u7624\u4e3aB\u7ec6\u80de\u6dcb\u5df4\u7624\uff0c\u5176\u4e2dMALT\u6dcb\u5df4\u7624\u548cDLBCL\u9891\u7387\u8f83\u9ad8\uff0c\u4e24\u8005\u536070\uff5e80%\u3002\u8fd1\u5e74\u6765\uff0c\u5341\u4e8c\u6307\u80a0\u3001\u7a7a\u80a0\u7684\u6ee4\u6ce1\u6027\u6dcb\u5df4\u7624\u4e0d\u65ad\u589e\u52a0\u3002T\u7ec6\u80de\u6dcb\u5df4\u7624\u53605\uff5e10%\uff0c\u6211\u56fd\u6210\u4ebaT\u7ec6\u80de\u767d\u8840\u75c5\/\u6dcb\u5df4\u7624\u548c\u80a0\u75c5\u76f8\u5173T\u7ec6\u80de\u6dcb\u5df4\u7624\u8f83\u591a\u3002<\/p>\n
3\u3001\u5206\u7c7b<\/p>\n
\u2014<\/p>\n
1. \u7ec4\u7ec7\u75c5\u7406\u5b66\u5206\u7c7b<\/p>\n
\u7ec4\u7ec7\u75c5\u7406\u5b66\u5206\u7c7b\u9075\u5faa WHO \u6dcb\u5df4\u80bf\u7624\u5206\u7c7b\u3002\u9664 HE \u67d3\u8272\u5916\uff0c\u514d\u75ab\u7ec4\u7ec7\u5316\u5b66\u67d3\u8272\u5bf9\u8bca\u65ad\u81f3\u5173\u91cd\u8981\u3002\u5728\u96be\u4ee5\u8bca\u65ad\u7684\u75c5\u4f8b\u4e2d\uff0c\u9996\u9009\u7ec6\u80de\u9057\u4f20\u5b66\u68c0\u6d4b [G \u663e\u5e26\u3001\u9006\u8f6c\u5f55-PCT (RT-PCR) \u6216\u8367\u5149\u539f\u4f4d\u6742\u4ea4] \u7279\u5f02\u6027\u57fa\u56e0\u5f02\u5e38\u3002<\/p>\n
1\uff09MALT\u6dcb\u5df4\u7624<\/p>\n
\u7ea6\u5360\u80c3\u6dcb\u5df4\u7624\u768440%\uff5e50%\uff0c\u7ea6\u5360\u80a0\u6dcb\u5df4\u7624\u768420%\u3002\u5176\u7279\u70b9\u662f\u53cd\u5e94\u6027\u6dcb\u5df4\u6ee4\u6ce1\u5916\u8fb9\u7f18\u533a\u5f25\u6f2b\u6027\u6d78\u6da6\u751f\u53d1\u4e2d\u5fc3\u6837\u7ec6\u80de\u548c\u6dcb\u5df4\u4e0a\u76ae\u75c5\u53d8\u3002\u514d\u75ab\u67d3\u8272\u663e\u793a CD20\u3001CD21 \u548c CD79a \u5448\u9633\u6027\uff0cCD3\u3001CD5\u3001CD10\u3001CD23 \u548c\u7ec6\u80de\u5468\u671f\u86cb\u767d D1 \u5448\u9634\u6027\u3002\u5728 15% \u81f3 30% \u7684\u75c5\u4f8b\u4e2d\u89c2\u5bdf\u5230\u7279\u5b9a\u7684\u67d3\u8272\u4f53\u6613\u4f4d t(11;18)(q21;q21)\/BIRC3-MALT1\uff0c\u5176\u4e2d\u8bb8\u591a\u6613\u4f4d\u9633\u6027\u75c5\u4f8b\u5bf9\u6839\u9664\u5e7d\u95e8\u87ba\u6746\u83cc\u6ca1\u6709\u53cd\u5e94\u3002<\/p>\n
2)DLBCL<\/p>\n
\u7ea6\u5360\u80c3\u548c\u80a0\u6dcb\u5df4\u7624\u768430-40%\u3002\u5b83\u8868\u73b0\u4e3a\u5927\u6bcd\u7ec6\u80de\u6837\u6dcb\u5df4\u6837\u80bf\u7624\u7ec6\u80de\u5f25\u6f2b\u6027\u3001\u6761\u7d22\u6837\u6216\u5b9e\u6027\u6d78\u6da6\u3002CD19\u3001CD20\u3001CD22\u3001CD79a\u7b49B\u7ec6\u80de\u6807\u5fd7\u7269\u5448\u9633\u6027\uff0cKi-67\u6807\u8bb0\u7387\u4e3a40%\u4ee5\u4e0a\u3002t(3;14)(q27;q32)\/BCL6-IGH\u3001t(8;14)(q24;q32)\/MYC-IGH\u6216 t(14;18)(q32;q21)\/IGH-BCL2\u7b49\u542bIGH\u533a\u7684\u67d3\u8272\u4f53\u6613\u4f4d\u536030 ~ 70 %\uff0cIGH\u6613\u4f4d\u9633\u6027\u75c5\u4f8b\u9884\u540e\u76f8\u5bf9\u8f83\u597d\u3002<\/p>\n
3\uff09\u6ee4\u6ce1\u6027\u6dcb\u5df4\u7624<\/p>\n
\u5360\u5c0f\u80a0\u6dcb\u5df4\u7624\u768420-25%\uff0c\u597d\u53d1\u4e8e\u5341\u4e8c\u6307\u80a0\u7a7a\u80a0\uff0c\u80c3\u548c\u5927\u80a0\u6d78\u6da6\u5c11\u89c1\u3002\u5448\u6ee4\u6ce1\u6837\u7ed3\u6784\u7684\u5c0f\u578b\u6dcb\u5df4\u80bf\u7624\u7ec6\u80de\u6d78\u6da6\u5f81\uff0cCD10\u3001BCL2\u3001BCL6\u9633\u6027\uff0cCD5\u3001CD43\u3001cyclinD1\u9634\u6027\u3002\u6839\u636e\u5927\u80bf\u7624\u7ec6\u80de\u7684\u6bd4\u4f8b\u5206\u4e3a\u4f4e\u7ea7\u522b\uff081\u7ea7\u30012\u7ea7\uff09\u548c\u9ad8\u7ea7\uff083A\u30013B\u7ea7\uff09\uff1b3B\u7ea7\u6ee4\u6ce1\u6027\u6dcb\u5df4\u7624\u4e0eDLBLC\u540c\u4e49\u3002\u5927\u7ea6 80% \u6709\u67d3\u8272\u4f53\u6613\u4f4d t(14;18)(q32;q21)\/IGH-BCL2\u3002<\/p>\n
4\uff09\u5176\u4ed6\u6dcb\u5df4\u7624<\/p>\n
B\u7ec6\u80de\u6dcb\u5df4\u7624\u5305\u62ec\u5957\u7ec6\u80de\u6dcb\u5df4\u7624\u548cBurkitt\u6dcb\u5df4\u7624\uff0cT\u7ec6\u80de\u6dcb\u5df4\u7624\u5305\u62ec\u6210\u4ebaT\u7ec6\u80de\u767d\u8840\u75c5\/\u6dcb\u5df4\u7624\u548c\u80a0\u75c5\u76f8\u5173T\u7ec6\u80de\u6dcb\u5df4\u7624\u3002<\/p>\n
2.\u5185\u955c\u8089\u773c\u5206\u7c7b<\/p>\n
\u80c3\u6dcb\u5df4\u7624\u7684\u5185\u955c\/\u8089\u773c\u6240\u89c1\u591a\u79cd\u591a\u6837\uff0c\u5206\u7c7b\u4e0d\u7edf\u4e00\uff0c\u4e34\u5e8a\u4e0a\u4f7f\u7528\u516b\u5c3e\u7684\u5206\u7c7b\uff08\u6d45\u8868\u578b\u3001\u80bf\u7624\u5f62\u6210\u578b\u3001\u5de8\u5927\u76b1\u895e\u578b\uff09\u548c\u4f50\u91ce\u7684\u5206\u7c7b\uff08\u6d45\u8868\u578b\u3001\u6e83\u75a1\u578b\u3001\u9686\u8d77\u578b\u3001\u7834\u6e83\u578b\u3001\u5de8\u5927\u76b1\u895e\u578b\uff09\u3002\u7b14\u8005\u7b49\u4eba\u4f7f\u7528\u4e86\u6ca1\u6709\u5b9a\u4e49\u6e83\u75a1\u578b\u7684\u516b\u5c3e\u5206\u7c7b\u4e3a\u57fa\u51c6\u7684\u5206\u7c7b\uff08\u6d45\u8868\u578b\u3001\u80bf\u7624\u3001\u5f25\u6f2b\u578b\u3001\u5176\u4ed6\u578b\uff09\u3002\u636e\u6b64\uff0c\u80c3MALT\u6dcb\u5df4\u7624\u768460\uff5e70\u4e3a\u6d45\u8868\u578b\uff0c\u5305\u62ec\u51f9\u51f8\u9897\u7c92\u72b6\u3001\u94fa\u77f3\u72b6\u9ecf\u819c\u3001\u80c3\u708e\u7c7b\u4f3c\u8868\u73b0\u30010-\u2161c\u7c7b\u4f3c\u51f9\u9677\u7b49\u591a\u79cd\u8868\u73b0\uff08\u56fe1a\uff09\u3002\u53e6\u4e00\u65b9\u9762\uff0c\u80c3DLBCL\u591a\u4e3a\u80bf\u7624\u578b\uff0c\u5e38\u6709\u6e83\u75a1\uff08\u7834\u6e83\u578b\uff09\uff0c\u9700\u8981\u4e0e1\u578b\u30012\u578b\u8fdb\u5c55\u764c\u8fdb\u884c\u9274\u522b\uff08\u56fe1b\uff09\u3002<\/p>\n<\/p>\n
\u56fe 1 \u80c3\u6dcb\u5df4\u7624\u5185\u955c\u56fe\u50cfa\uff0e\u80c3 MALT \u6dcb\u5df4\u7624\uff08\u6d45\u8868\u578b\uff09 b\uff0e\u80c3\u578b DLBCL\uff08\u80bf\u7624\u578b\uff09<\/p>\n
\u80a0\u9053\u6dcb\u5df4\u7624\u7684\u8089\u773c\u5f62\u6001\u66f4\u4e3a\u591a\u6837\uff0c\u5c06\u5176\u5206\u4e3a5\u79cd\u7c7b\u578b\uff1a\u9686\u8d77\u578b\u3001\u6e83\u75a1\u578b\u3001MLP\u578b\u3001\u5f25\u6f2b\u578b\u548c\u6df7\u5408\u578b\u3002\u6e83\u75a1\u578b\u6700\u591a\uff0c\u53ef\u7ec6\u5206\u4e3a3\u79cd\u7c7b\u578b\uff1a\u72ed\u7a84\u578b\u3001\u975e\u72ed\u7a84\u578b\u548c\u52a8\u8109\u7624\u578b\u3002\u7ec4\u7ec7\u578b\u4e2dDLBCL\u5360\u5927\u534a\u3002\u52a8\u8109\u7624\u578b\u662f\u75c5\u53d8\u90e8\u80a0\u9053\u76f8\u5bf9\u4e8e\u975e\u75c5\u53d8\u90e8\u7684\u6269\u5f20\uff0c\u662f\u80a0\u9053\u6dcb\u5df4\u7624\u7684\u5178\u578b\u8868\u73b0\u3002\u72ed\u7a84\u578b\u4e2d\u4e0e\u764c\u7684\u9274\u522b\u662f\u4e2a\u95ee\u9898\u3002\u9686\u8d77\u578b\u4e2dMALT\u6dcb\u5df4\u7624\u548cDLBCL\u7684\u9891\u7387\u8f83\u9ad8\u3002MLP\u578b\u53ef\u5e7f\u6cdb\u5448\u73b0\u65e0\u6570\u9686\u8d77\u6027\u75c5\u53d8\uff0c\u591a\u89c1\u4e8e\u6ee4\u6ce1\u6027\u6dcb\u5df4\u7624\u548c\u5957\u7ec6\u80de\u6dcb\u5df4\u7624(\u56fe2 )\u3002\u5f25\u6f2b\u578b\u4e0d\u5f62\u6210\u80bf\u7624\u548c\u6e83\u75a1\uff0c\u5f25\u6f2b\u6027\u5730\u53d1\u73b0\u76b1\u895e\u80bf\u5927\uff0c\u8fd9\u662fT\u7ec6\u80de\u6dcb\u5df4\u7624\u548cIPSID\u7684\u7279\u5f81\u3002<\/p>\n<\/p>\n
\u56fe2 \u5c0f\u80a0\u6ee4\u6ce1\u6027\u6dcb\u5df4\u7624\uff08MLP\u578b\uff09<\/p>\n
\u5982\u4e0a\u6240\u8ff0\uff0c\u8089\u773c\u578b\u4e0e\u7ec4\u7ec7\u578b\u76f8\u5173\u3002\u5728\u5f71\u50cf\u8bca\u65ad\u4e2d\uff0c\u4e0e\u764c\u7684\u9274\u522b\u5f88\u91cd\u8981\uff0c\u4f46\u9686\u8d77\u578b\u75c5\u53d8\u4e0eGIST\uff0c\u5f25\u6f2b\u578b\u4e0e\u6dc0\u7c89\u6837\u53d8\u6027\u548c\u5bc4\u751f\u866b\u75be\u75c5\uff0cMLP\u578b\u4e0e\u5404\u79cd\u6d88\u5316\u9053\u606f\u8089\u7b49\u9274\u522b\u75be\u75c5\u3002<\/p>\n
3. \u4e34\u5e8a\u5206\u671f<\/p>\n
\u5bf9\u4e8e\u786e\u5b9a\u6cbb\u7597\u7b56\u7565\u5f88\u91cd\u8981\u3002\u63a8\u8350Lugano\u56fd\u9645\u4f1a\u8bae\u5206\u7c7b\uff08I\u3001II 1\u3001II 2\u3001II E\u3001IV\uff09\u3002<\/p>\n
4\u3001\u6cbb\u7597<\/p>\n
\u2014<\/p>\n
\u6cbb\u7597\u7b56\u7565\u53d6\u51b3\u4e8e\u75c5\u53d8\u7684\u8303\u56f4\u3001\u7ec4\u7ec7\u5b66\u548c\u4e34\u5e8a\u5206\u671f\u3002<\/p>\n
1.\u80c3MALT\u6dcb\u5df4\u7624\u7684\u6cbb\u7597<\/p>\n
1 \uff09 Hp\u9664\u83cc\u7597\u6cd5<\/p>\n
\u56fd\u5185\u5916\u6307\u5357\u8bb0\u8f7d\u4e86\u2160\/\u21611\u671f\u7684\u80c3MALT\u6dcb\u5df4\u7624\u7684\u9996\u9009\u6cbb\u7597\u65b9\u6cd5\uff0c60\uff5e80%\u7684\u75c5\u4f8b\u53ef\u4ee5\u5f97\u5230\u5b8c\u5168\u7f13\u89e3\uff08CR\uff09\u3002\u636e\u62a5\u544a\uff0c\u9664\u83cc\u540e\u5230CR\u4e3a\u6b62\u7684\u65f6\u95f4\u4e3a1\uff5e24\u4e2a\u6708\uff0c\u4e2d\u95f4\u503c\u4e3a2\uff5e6\u4e2a\u6708\u3002\u6cbb\u7597\u540e\u6d3b\u68c0\u6807\u672c\u7684\u75c5\u7406\u7ec4\u7ec7\u5b66\u5224\u5b9a\u9075\u5faaGELA\u7684\u7ec4\u7ec7\u5206\u7ea7\u7cfb\u7edf\u3002Hp\u9634\u6027\uff0ct\uff0811\uff1b18\uff09\uff08q21\uff1bq21\uff09\/BIRC3-MALT1\u6613\u4f4d\u3001\u8fd1\u7aef\u80c3\u5b9a\u4f4d\u3001\u80c3\u58c1\u6df1\u6d78\u6da6\u3001\u8fdb\u5c55\u671f\u7b49\u662f\u6839\u9664\u8010\u836f\u7684\u56e0\u7d20\u3002<\/p>\n
2\uff09\u6839\u9664\u96be\u6cbb\u75c5\u4f8b\u7684\u6cbb\u7597\u7b56\u7565<\/p>\n
\u5bf9\u4e8e\u6839\u9664\u6cbb\u7597\u4e0d\u80fd\u8fbe\u5230CR\u7684\u80c3MALT\u6dcb\u5df4\u7624\uff0c\u76ee\u524d\u5c1a\u65e0\u6807\u51c6\u6cbb\u7597\u65b9\u6848\u3002\u5982\u679c\u5728\u7597\u7a0b\u4e2d\u89c2\u5bdf\u5230\u6dcb\u5df4\u7624\u8fdb\u5c55\uff08PD\uff09\uff0c\u5219\u8fdb\u884c\u4e8c\u7ebf\u6cbb\u7597\uff0c\u4f46\u5982\u679c\u51fa\u73b0\u90e8\u5206\u7f13\u89e3\u6216\u65e0\u53d8\u5316\uff0c\u63a8\u83502\u5e74\u4e0d\u8fdb\u884c\u8ffd\u52a0\u6cbb\u7597\uff0c\u5efa\u8bae\u91c7\u7528\u89c2\u5bdf\u7b49\u5f85\u7b56\u7565\u3002<\/p>\n
\u4f5c\u4e3a\u8ffd\u52a0\u6cbb\u7597\uff0c\u591a\u9009\u62e9\u653e\u7597\u6216\u5316\u7597\u3002\u5bf9\u4e8e\u2160 \/ \u2161 1\u671f\u75c5\u4f8b\uff0c\u65e5\u672c\u548c\u7f8e\u56fd\u7684\u6307\u5357\u4e2d\u63a8\u8350\u653e\u7597\u6cd5\uff0c\u4f46\u6b27\u6d32\u7684\u6307\u5357\u4e2d\u5c06\u653e\u7597\u548c\u5316\u7597\u540c\u7b49\u8bb0\u8f7d\u3002\u5bf9\u4e8e\u6ca1\u6709PD\u7684\u4e0d\u53d8\u4f8b\uff0c\u53e3\u670d\u70f7\u5316\u5242\u5355\u836f\u7597\u6cd5(\u73af\u78f7\u9170\u80fa\u7b49)\u548c\u6297CD20\u6297\u4f53\u5229\u59a5\u6614\u5355\u836f\u7597\u6cd5\u662f\u6709\u6548\u7684\u3002\u5bf9\u4e8e\u75c5\u671f\u8fdb\u5c55\u4f8b\u548cPD\u4f8b\uff0c\u4f7f\u7528\u5229\u59a5\u6614\u5355\u6297\u8054\u5408CHOP (\u73af\u78f7\u9170\u80fa+\u5f3a\u529b\u9709\u7d20+\u957f\u6625\u65b0\u78b1+\u6cfc\u5c3c\u677e\u9f99: R-CHOP )\u7597\u6cd5\uff0c\u4e5f\u8fdb\u884c\u5229\u59a5\u6614\u5355\u6297\u548c\u6297\u764c\u836f\u7269\u5355\u836f(\u6c1f\u8fbe\u62c9\u6ee8\u6216\u82ef\u8fbe\u666e\u5229)\u7684\u7ec4\u5408\u3002<\/p>\n
2 .\u80c3DLBCL\u7684\u6cbb\u7597<\/p>\n
1 ) Hp\u9664\u83cc\u6cbb\u7597<\/p>\n
\u56fd\u5185\u5916\u5747\u62a5\u9053Hp\u9633\u6027\u3001I\/II\u671f1\u671f\u80c3DLBCL\u7ecfHp\u9664\u83cc\u540e\u53ef\u83b7\u5f9730 ~ 60 %\u7684CR\u3002MALT \u6dcb\u5df4\u7624\u6210\u5206\u7684\u5b58\u5728\u4e0e\u5426\u4e0e\u6839\u9664\u53cd\u5e94\u65e0\u5173\u3002\u867d\u7136\u6307\u5357\u4e2d\u6ca1\u6709\u660e\u786e\u8bb0\u8f7d\uff0c\u4f46\u8ba4\u4e3a\u662f\u5e94\u8be5\u5c1d\u8bd5\u4e00\u6b21\u7684\u6cbb\u7597\u3002<\/p>\n
2\uff09\u6839\u9664\u96be\u6cbb\u75c5\u4f8b\u6cbb\u7597\u7b56\u7565 <\/p>\n
\u6839\u9664\u65e0\u6548\u7684\u80c3DLBCL\uff0cI\/II\u671f1\u671f\u60a3\u8005\u63a5\u53d73\u4e2a\u7597\u7a0b\u7684R-CHOP\u6cbb\u7597+\u653e\u7597\uff0cII\u671f\u53ca\u4ee5\u4e0a\u665a\u671f\u60a3\u8005\u63a5\u53d7R-CHOP\u6cbb\u7597. \u63a8\u83506-8\u4e2a\u7597\u7a0b\u3002\u8fc7\u53bb\u5e7f\u6cdb\u5f00\u5c55\u7684\u624b\u672f\u5207\u9664\u5f80\u5f80\u5c40\u9650\u4e8e\u5927\u51fa\u8840\u3001\u7a7f\u5b54\u3001\u96be\u6cbb\u6027\u60a3\u8005\u7684\u62a2\u6551\u6216\u975e\u624b\u672f\u6cbb\u7597\u671f\u95f4\u7684\u80c3\u764c\u5e76\u53d1\u75c7\u7b49\u60c5\u51b5\u3002<\/p>\n
3. \u80a0\u6dcb\u5df4\u7624\u7684\u6cbb\u7597 <\/p>\n
\u80a0DLBCL\u7b49\u4e2d\/\u9ad8\u5ea6\u6076\u6027\u6dcb\u5df4\u7624\uff0cI\/II1\u671f\u7684\u5c40\u9650\u671f\u6cbb\u7597\u5e38\u91c7\u7528\u624b\u672f\u5207\u9664\u548c\u672f\u540e\u5316\u7597\uff08CHOP\u6216R-CHOP\u7597\u6cd5\uff09\u3002I\/II1\u671f\u5341\u4e8c\u6307\u80a0\u5c0f\u80a0\u6ee4\u6ce1\u6027\u6dcb\u5df4\u7624\u60a3\u8005\u53ef\u9009\u62e9\u89c2\u5bdf\u7b49\u5f85\u7b56\u7565\u62164-8\u4e2a\u7597\u7a0b\u7684\u5229\u59a5\u6614\u5355\u6297\u5355\u836f\u6cbb\u7597\u3002\u5341\u4e8c\u6307\u80a0\u548c\u76f4\u80a0\u7684 MALT \u6dcb\u5df4\u7624\u548c IPSID \u53ef\u80fdHp\u9664\u83cc\u7b49\u6297\u83cc\u836f\u7269\u6cbb\u7597\u6709\u53cd\u5e94\u3002<\/p>\n
\u5bf9\u4e8e\u5176\u4ed6\u7ec4\u7ec7\u578b\u6216\u21612\u671f\u4ee5\u4e0a\u7684\u8fdb\u5c55\u671f\u75c5\u4f8b\uff0c\u591a\u8fdb\u884c6\uff5e8\u4e2a\u7597\u7a0b\u7684CHOP\u6216R-CHOP\u7597\u6cd5\u3002\u5bf9\u4e8e\u6076\u6027\u5ea6\u9ad8\u7684\u5957\u6dcb\u5df4\u7624\uff0cBurkitt\u6dcb\u5df4\u7624\uff0c\u90e8\u5206T\u7ec6\u80de\u6dcb\u5df4\u7624\uff0c\u8003\u8651\u9020\u8840\u5e72\u7ec6\u80de\u79fb\u690d\u8054\u5408\u5927\u5242\u91cf\u5316\u7597\u3002<\/p>\n
5\u3001\u9884\u540e<\/p>\n
\u2014<\/p>\n
1 .\u80c3MALT\u6dcb\u5df4\u7624\u7684\u9884\u540e<\/p>\n
\u636e\u62a5\u9053\uff0c\u9664\u83cc\u6cbb\u7597\u83b7\u5f97CR\u540e\uff0c\u80c3MALT\u6dcb\u5df4\u7624\u7684\u590d\u53d1\u7387\u4e3a2 ~ 10 %\u3002\u5185\u955c\u4e0b\u65e0\u6cd5\u6307\u51fa\u75c5\u53d8\u7684\u75c5\u7406\u7ec4\u7ec7\u5b66\u590d\u53d1\u75c5\u4f8b\u591a\u5728\u65e0\u6cbb\u7597\u7684\u60c5\u51b5\u4e0b\u6d88\u5931\uff0c\u4e0d\u9700\u8981\u8ffd\u52a0\u6cbb\u7597\u3002\u65e5\u672c\u7684\u4e00\u9879\u5927\u89c4\u6a21\u961f\u5217\u7814\u7a76\u4e2d\uff0c\u9664\u83cc10\u5e74\u540e\u7684\u6cbb\u7597\u5931\u8d25\u907f\u514d\u7387\u3001\u603b\u751f\u5b58\u7387\u53ca\u65e0\u4e8b\u4ef6\u751f\u5b58\u7387\u5206\u522b\u4e3a90 %\u300195 %\u53ca86 %\uff0c\u8bc1\u5b9e\u4e86\u6781\u597d\u7684\u957f\u671f\u9884\u540e\u3002\u53e6\u4e00\u65b9\u9762\uff0c\u5728\u75c5\u7a0b\u89c2\u5bdf\u4e2d\u6709\u65f6\u4f1a\u53d1\u751f\u4f4e\u9891\u7387(3 %\u4ee5\u4e0b)\u5f02\u65f6\u6027\u80c3\u764c\uff0c\u56e0\u6b64\u9700\u8981\u957f\u671f\u5b9a\u671f\u8fdb\u884c\u5185\u955c\u68c0\u67e5\u3002<\/p>\n
2.\u80c3DLBCL\u7684\u9884\u540e<\/p>\n
\u636e\u62a5\u544a\u5916\u79d1\u5207\u9664\u7684\u2160\/\u21611\u671f\u75c5\u4f8b\u7684\u672f\u540e5\u5e74\u603b\u751f\u5b58\u7387\uff0c\u5305\u62ec\u8ffd\u52a0\u5316\u7597\u75c5\u4f8b\u5728\u5185\uff0c\u4e3a67\uff5e80%\u3002Avil\u00e9s\u6839\u636e589\u4f8b\u524d\u77bb\u60274\u7ec4\u968f\u673a\u5316\u7814\u7a76\u7684\u7ed3\u679c\uff0c10\u5e74\u540e\u65e0\u4e8b\u4ef6\u751f\u5b58\u7387\u4e3a\u5316\u7597\u5355\u72ec\u7ec492%\uff0c\u624b\u672f+\u5316\u7597\u7ec482%\uff0c\u624b\u672f+\u653e\u7597\u7ec423%\uff0c\u5355\u7eaf\u624b\u672f\u7ec4\u4e3a 28%\u3002\u56e0\u6b64\uff0c\u5efa\u8bae\u5316\u7597\u4f18\u4e8e\u624b\u672f\u5207\u9664\u3002<\/p>\n
3 .\u80a0\u9053\u6dcb\u5df4\u7624\u7684\u9884\u540e<\/p>\n
\u9884\u540e\u6bd4\u80c3\u539f\u53d1\u6dcb\u5df4\u7624\u5dee\u3002\u9884\u540e\u56e0\u7d20\u6709\u4e34\u5e8a\u5206\u671f\u3001T\/B\u514d\u75ab\u8868\u578b\u3001\u75c5\u7406\u7ec4\u7ec7\u5b66\u6076\u6027\u7a0b\u5ea6\u3001\u6cbb\u6108\u5207\u9664\u3001\u75c7\u72b6\u3001\u6709\u65e0\u7a7f\u5b54\u7b49\u3002<\/p>\n
\uff08\u53c2\u8003\u6587\u732e\u6765\u6e90\u6d88\u5316\u5185\u955c\uff0c\u672c\u516c\u4f17\u53f7\u4ec5\u4f9b\u5b66\u4e60\u4e4b\u7528\uff0c\u5982\u6709\u4fb5\u6743\uff0c\u8bf7\u8054\u7cfb\u5220\u9664\uff0c\u6b22\u8fce\u8f6c\u53d1\u4ea4\u6d41\uff09<\/p>\n","protected":false},"excerpt":{"rendered":"
1\u3001\u75be\u75c5\u6982\u5ff5\u3001\u75c5\u56e0 \u2014 \u6076\u6027\u6dcb\u5df4\u7624\u5206\u4e3a\u7ed3\u5185\u6dcb\u5df4\u7624\u548c\u7ed3\u5916\u6dcb\u5df4\u7624\u300230% \u81f3 40% … \u7ee7\u7eed\u9605\u8bfb