Analysis of clinical features in pulmonary lymphoma / 白血病·淋巴瘤

ABSTRACT

Objective To investigate the clinical features of pulmonary lymphoma and to get a better understanding of this disease. Methods Clinical data of 253 lymphoma patients in the Department of Lymphoma and Hematology in Jilin Cancer Hospital from October 2014 to March 2017 were retrospectively analyzed. The patients were divided into 30 cases of pulmonary lymphoma (lung lymphoma group) and 223 cases of non-pulmonary lymphoma (the control group). Rate assay and latex turbidimetry was used to detect lactic dehydrogenase (LDH) and β2macroglobulin (β2-MG) respectively. The expressions of programmed death 1 (PD-1), programmed death ligand 1 (PD-L1) and cytotoxic T lymphocyte-associated antigen 4 (CTLA-4) in peripheral blood CD4 +CD8 +T lymphocytes were detected by using flow cytometry. The count and measurement data of both groups were compared by using χ 2test and t test respectively. Results The patients in pulmonary lymphoma group showed secondary lesions. The proportion of smoking people in pulmonary lymphoma group was higher than that in the control group [43.3 % (13/30) vs. 24.2 % (54/223), χ 2＝ 4.964, P＝ 0.026]. The proportion of the patients in Ⅲ-Ⅳ stage in pulmonary lymphoma group was higher than that in the control group [93.3 % (28/30) vs. 57.0 % (127/223), χ2＝ 14.750, P < 0.001]. The proportion of the patients with higher international prognostic index (IPI) score in pulmonary lymphoma group was higher than that in the control group (χ2＝ 21.888, P < 0.001). The proportion of the patients with increased expression of β2-MG in pulmonary lymphoma group was higher compared with the control group [66.7 % (20/30) vs. 50.2 % (112/223), χ2＝6.682, P ＝0.091]. The proportion of the patients with the increased LDH was higher compared with the control group [63.3 % (19/30) vs. 41.5 % (86/223)], and the difference was statistically significant (χ2＝ 6.682, P ＝ 0.010). Diffuse large B-cell lymphoma (DLBCL) was the common pathological type in pulmonary lymphoma group (15 cases), followed by Hodgkin lymphoma (7 cases); imaging showed single mass or nodular type, multiple masses or nodular type, bilateral pulmonary infiltration, pleural effusion were 36.7 % (11/30), 30.0 % (9/30), 63.3 % (19/30) and 36.7 % (11/30), respectively. There were no statistical differences in the protein expression of immune check points such as PD-1, PD-L1 and CTLA-4 in both groups (all P ＞ 0.05). Conclusions Pulmonary DLBCL should be considered a secondary disease, but not a primary lesion. Smoking history is a risk factor for lymphoma patients with pulmonary involvement. Pulmonary lymphoma is similar to other extra-nodal lymphoma with high IPI scores, advanced stage and elevated LDH.