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

Öz

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.

Anahtar Kelimeler

• Non-Hodgkin Lenfoma epidemiyoloji,Histolojik alttipleri

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

Öz

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.

Anahtar Kelimeler

• Non-Hodgkin’s lymphoma; epidemiology,histologic subtype

Kaynakça

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