Korean Journal of Head & Neck Oncology (대한두경부종양학회지)

The Korean Society for Head and Neck Oncology (대한두경부종양학회)
권호 표지

Clinical Features and Prognostic Factors in 41 Patients of Primary Nasal/Nasopharyngeal Non-Hodgkin's Lymphoma: Prognostic Significance of Immunophenotype

비/비인강 비호즈킨 림프종의 임상양상과 예후 인자 : 면역 표현형의 임상적 의의

  • Park Soon-Seo (Departments of Medicine, Asan Medical Center, Univesity of Ulsan, Collge of Medicine) ;
  • Park Jong-Beom (Departments of Medicine, Asan Medical Center, Univesity of Ulsan, Collge of Medicine) ;
  • Suh Cheol-Won (Departments of Medicine, Asan Medical Center, Univesity of Ulsan, Collge of Medicine) ;
  • Park Ji-Woon (Departments of Medicine, Asan Medical Center, Univesity of Ulsan, Collge of Medicine) ;
  • Lim Soo-Duk (Departments of Pathology, Asan Medical Center, Univesity of Ulsan, Collge of Medicine) ;
  • Huh Joo-Ryung (Departments of Pathology, Asan Medical Center, Univesity of Ulsan, Collge of Medicine) ;
  • Nam Soon-Yuhl (Departments of Otolaryngology, Asan Medical Center, Univesity of Ulsan, Collge of Medicine) ;
  • Kim Sang-Yoon (Departments of Otolaryngology, Asan Medical Center, Univesity of Ulsan, Collge of Medicine) ;
  • Lee Ho-Gyu (Departments of Radiology, Asan Medical Center, Univesity of Ulsan, Collge of Medicine) ;
  • Chang Hye-Sook (Departments of Radiation Oncology, Asan Medical Center, Univesity of Ulsan, Collge of Medicine) ;
  • Kim Tae-Won (Departments of Medicine, Asan Medical Center, Univesity of Ulsan, Collge of Medicine) ;
  • Lee Je-Hwan (Departments of Medicine, Asan Medical Center, Univesity of Ulsan, Collge of Medicine) ;
  • Kim Sung-Bae (Departments of Medicine, Asan Medical Center, Univesity of Ulsan, Collge of Medicine)
  • 박순서 (울산대학교 의과대학 서울중앙병원 내과학교실) ;
  • 서철원 (울산대학교 의과대학 서울중앙병원 내과학교실) ;
  • 박종범 (울산대학교 의과대학 서울중앙병원 내과학교실) ;
  • 박지운 (울산대학교 의과대학 서울중앙병원 내과학교실) ;
  • 임소덕 (울산대학교 의과대학 서울중앙병원 진단병리과학교실) ;
  • 허주령 (울산대학교 의과대학 서울중앙병원 진단병리과학교실) ;
  • 남순열 (울산대학교 의과대학 서울중앙병원 이비인후과학교실) ;
  • 김상윤 (울산대학교 의과대학 서울중앙병원 이비인후과학교실) ;
  • 이호규 (울산대학교 의과대학 서울중앙병원 진단방사선과학교실) ;
  • 장혜숙 (울산대학교 의과대학 서울중앙병원 방사선종양학과학교실) ;
  • 김태원 (울산대학교 의과대학 서울중앙병원 내과학교실) ;
  • 이제환 (울산대학교 의과대학 서울중앙병원 내과학교실) ;
  • 김성배 (울산대학교 의과대학 서울중앙병원 내과학교실)
  • Published : 1999.11.01
Download PDF
⟨ Previous Next ⟩

Abstract

Objectives: To study the clinical features of the primary nasal/nasopharyngeal non-Hodgkin's lymphomas and to evaluate the implication of immunophenotyping as a prognostic factor. Patients and Methods: From January 1990 to December 1997,41 patients(median age, 41 years) of primary nasal/nasopharyngeal non-Hodgkin's lymphoma were studied. The clinical records and paraffin-embedded tissue blocks were reviewed retrospectively. The histologic features, immunophenotypic findings(pan-T, pan-B, CD3, CD56) and Epstein-Barr virus in situ hybridizatios were examined. The prognostic factors for clinical outcome were evaluated in these patients. According to Ann-Arbor system, there were 30 patiets(73%) with stage IE, 4(10%) with stage IIE, 3(7%) with stage IIIE, 4(10%) with stage IVE lymphoma. Among the patients with stage IE/IIE, 4 patients received local radiation alone, 4 received chemotherapy alone, 25 received combination chemotherapy and radiotherapy and 1 refused treatment. The patients with stage IIIE/IVE were given combination chemotherapy and radiotherapy. Results: Immunophenotyping were performed in 40 patients and staining results were as follows: 3(7%) patients with B cell, 17(42%) with T cell, 18(44%) with NK/T cell(CD56 positive), and two patients with unclassifiable result. Epstein-Barr(EB) virus in situ hybridization were performed in 28 patients and 23(82%) patients had positive EBV-encoded RNAs(EBERs). 21(55%) patients achieved a complete remission. There was no difference in complete remission between radiation alone and combination therapy. With median follow-up of 30 months, 5-years disease free survival of complete responders was 60% and 5-years overall survival rate was 36%. Multivariate analysis showed that better overall survival was related with absence of B symptoms, ECOG performance${\leq}1$ and non-NK cells. Conclusion: Most of all cases were positive for EBER. Since NK/T phenotype carried the worst prognosis, analysis for CD56 expression should be done. Further prospective studies were warranted to evaluate the role of chemotherapy in stage IE/IIE.

Keywords