Güneydoğu Anadolu Bölgesindeki Non-Hodgkin Lenfoma Sınıflaması: 550 Hastanın İncelenmesi

Year 2019, Volume: 16 Issue: 3, 556 - 561, 25.12.2019

Mehmet Önder Ekmen , Sinan Dal , Abdullah Karakuş Hüseyin Büyükbayram Mehmet Orhan Ayyıldız

https://doi.org/10.35440/hutfd.627797

Abstract

Amaç: Hodgkin olmayan lenfoma
(NHL) alt tiplerinin dağılması tüm dünyada farklılık gösterir. Bu çalışmada,
Ocak 2005- Aralık 2014 tarihleri arasında hastanemize başvuran NHL hastalarında
cinsiyet, yaş, alt tipler, biyopsi alanları, nodal ve ekstranodal yerleşim
alanı ve hastalığın evrelerini değerlendirmeyi amaçladık.

Materyal ve Metod: Ocak 2005- Aralık 2014
tarihleri arasında hastanemize başvuran NHL hastalarının dosyaları retrospektif
olarak tarandı.

Bulgular: 550 hastanın 335'i (%60,9)
erkek, 215'i (%39,1) kadındı. Tüm hastaların üzerinde yaş ortalaması 56 idi
(15-95). Kadınların yaş ortalaması 57 (15-88), erkeklerin yaş ortalaması 54
(15-95) idi. NHL hastalarının histolojik alt tipleri şu şekildedir: 447 hasta (%81,3)
B hücreli lenfoma, 84 hasta (%15,2) T / NK hücre lenfoması, 19 hasta (% 3.5)
sınıflandırılmamış alt tip. NHL hastaları 2001 ve 2008 WHO (Dünya Sağlık
Örgütü) Sınıflandırmasına ve histopatolojik alt tiplerine göre alt tiplere
ayrıldı: Diffüz Büyük B Hücreli Lenfoma (DLBCL) 295 hasta (% 53,63), küçük
lenfositik lenfoma (SLL) 37 hasta ( % 6.7), Ekstranodal marjinal bölge
lenfoması (MALT tipi) 37 hasta (% 6,75), periferik T hücreli Lenfoma 27 hasta
(% 4,9), manto hücreli lenfoma 26 hasta (% 4,72), Nodal Marjinal Bölge B-Hücre
Lenfoması 7 hasta (% 1,3), 12 hastada foliküler lenfoma (% 2,1), Burkitt
lenfoma 7 hasta (% 1,3), Splenik marjinal bölge B hücreli lenfoma 4 hasta
(0,7). NHL'nin en sık görülen alt tipi DLBCL 295 hastasıydı (%53,63). Foliküler
lenfomalar merkezimizde daha az görülür. Ekstranodal invlolvement oranı
hastaların%38,5'i idi. Ekstranodal NHL'lerin bölgelerinin dağılımına göre,
hastaların%43'ünde GI kanal tutulumu vardı. En sık etkilenen GI bölgeleri mide
idi (%27,8). Bu çalışmada, hastaların %22,9'u Evre 1, Evre 2'de%26,7, Evre 3'te%19,5,
Ann-Arbor sınıflandırmasına göre Evre 4'te%30,9 idi.

Sonuç: NHL hastalarının
özellikleri coğrafi farklılıklara göre değişmektedir. Bu çalışma geriatrik
değerlendirmenin önemini ortaya koydu. NHL erkeklerde daha sık gözlendi.
Çevresel risk faktörleri epidemiyolojik olarak araştırılmalıdır. NHL'nin en
yaygın alt tipi DLBL'dir. Foliküler lenfomalar merkezimizde daha az görülür.
Ulusal kanser kayıt sisteminin iyileştirilmesi ve NHL'nin erken tanı ve
tedavisini sağlamak için tedavi protokollerini gözden geçiren çok merkezli
büyük ölçekli çalışmalara ihtiyaç vardır.

Keywords

Non-Hodgkin Lenfoma epidemiyoloji, Histolojik alttipleri

Classification of Non-Hodgkin Lymphoma in Southeast Turkey: A Review of 550 Cases

Abstract

Background: The
distribution of non-Hodgkin lymphoma (NHL) subtypes differs around the world.
In this study we aimed to evaluate the gender, age, subtypes, biopsy sites,
nodal and extranodal residential area, and stage of disease in the patients
with NHL admitted to our hospital between January 2005 and December 2014.

Materials and Methods: The records of
NHL patients admitted to our hospital between January 2005 and December 2014
were retrospectively reviewed

Results: Among 550
patients, 335 patients (60.9%) were male, 215 patients (39.1%) were female. The
average age of over all the patients was 56 years (15-95). The average age of
women was 57 (15-88), the average age of men was 54 years (15-95). The
histological subtypes of NHL patients were as follows: 447 patients (81.3%)
B-cell lymphoma, 84 patients (15.2%) T / NK cell lymphoma, 19 patients (3.5%)
unclassified subtype. NHL patients divided into subtypes according  to 2001 and 
2008 WHO (World Health Organization) Classification and histopathologic
subtypes were as follow: Diffuse Large B Cell Lymphoma (DLBCL) 295 patients
(53,63%), small lymphocytic lymphoma (SLL) 37 patients (6.7%), Extranodal
marginal zone lymphoma (MALT type) 37 patients (6,75%), peripheral T-cell
Lymphoma 27 patients (4.9%), mantle cell lymphoma 26 patients (4.72%), Nodal
Marginal Zone B-Cell Lymphoma 7 patients (1,3%), follicular lymphoma in 12
patients (2.1%), Burkitt's lymphoma 7 patients (1.3%), Splenic marginal zone
B-cell lymphoma 4 patients (0,7). The most common subtype of NHL was DLBCL 295
patients (53,63%). Follicular lymphomas are less common in our center.
Extranodal involvement rate was 38,5% of patients. According to the
distribution of the sites of extranodal NHLs, the vast majority of patients 43%
had GI tract involvement. The most commonly affected GI sites were stomach (27,8%).
In this study 22.9% of the patients were in Stage 1, 26.7% in Stage 2, 19.5% in
Stage 3, 30.9% in Stage 4 according to Ann- Arbor classification. In
conclusion, the characteristics of NHLs in our region show
some differences from other sites of the world.

Conclusions: The
characteristics of NHL patients vary according to geographical
differences.  Present study has revealed
the importance of geriatric assessment. NHL was observed frequently in men.
Environmental risk factors have to research, epidemiologically.  The most common subtype of NHL was DLBL.
Follicular lymphomas are less common in our center. Improvement of national
cancer registration system and multicenter large-scale studies reviewing the
treatment protocols are needed to ensure the early diagnosis and therapy of
NHL.

Keywords

Non-Hodgkin’s lymphoma; epidemiology, histologic subtype

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