Non-Hodgkin's Lymphoma Treatment
an examination
NHL examinations can be divided into traumatic and non-traumatic examinations. Traumatic examinations are mostly carried out by taking histological specimens for diagnosis, while non-invasive examinations are mostly carried out for finding the location of the lesion, evaluating the extent of the lesion and evaluating the therapeutic effect.
1. Traumatic examination
The method of operation is determined mainly according to the size of the lesion, the location of growth and the possible risks that may be brought by the trauma examination. ① Direct puncture of superficial enlarged lymph nodes; or percutaneously puncture cells of deep lymph nodes and space-occupying lesions to obtain specimens under the guidance of ultrasound and CT positioning. The value of this method is somewhat controversial. ②According to the location of the lesion, tissue cell samples can be taken with the assistance of bronchoscopy, mediastinoscopy, gastroscopy, colonoscopy and other endoscopes. ③ Obtain cell specimens of lymph nodes or lesions by various surgical methods. ④Bone marrow aspiration and biopsy. ⑤ Lumbar puncture for cerebrospinal fluid cytology examination.
2. Non-traumatic examination
① Laboratory tests include complete blood count, erythrocyte sedimentation rate, lactate dehydrogenase, β2 microglobulin, liver and kidney function, etc. ② Imaging examinations include whole body CT, magnetic resonance, positron emission tomography (PET/CT), etc.
3. Other
Evaluative examination of general general condition of the whole body.
diagnosis
The diagnosis of NHL must be confirmed by pathology. At the same time, according to the morphological characteristics of tissue cells, combined with immunophenotype and cytogenetic characteristics, the pathological type can be clarified, which is beneficial to guide individualized treatment medication and judge prognosis. High incidence and representative NHL:
1. B cell type
Diffuse large B-cell lymphoma, follicular lymphoma, mantle cell lymphoma, mucosa-associated lymphoid tissue lymphoma.
2. T cell types
Peripheral T cell lymphoma, angioimmunoblastic lymphoma, anaplastic large cell lymphoma.
3.NK/T cells
Extranodal NK/T cell lymphoma-nasal type, aggressive NK/T cell leukemia.
treatment
With the continuous research and understanding of the immunology, cytogenetics and molecular biology characteristics of NHL, the research and development of new drugs, the complete clinical staging, the analysis of comprehensive factors such as the International Prognostic Index (IPI) of lymphoma, the treatment of individuals The requirements for chemistry become higher and higher, and the treatment becomes more and more complicated. At present, the main treatment methods include systemic chemotherapy, local radiotherapy, biological immunology, surgical removal of part or all of the lesions, hematopoietic stem cell transplantation, or anti-H. pylori infection treatment for gastric mucosal-related tissue lymphoma caused by Helicobacter pylori infection.
In the actual work of NHL, it can be divided into highly aggressive, aggressive and inert NHL according to the tumor cell proliferation speed and clinical characteristics. Highly aggressive NHL tumors proliferate rapidly and are prone to invasion of other organs, such as lymphoblastic lymphoma and Burkitt lymphoma. Although the degree of malignancy is high, there is a potential for cure. High-dose intensity or acute lymphocytic leukemia-like regimens are often used. Indolent NHL tumor cells proliferate slowly, but they are relatively insensitive to chemotherapy and are tumors that cannot be cured by chemotherapy. Treatment can improve the quality of life and prolong survival time. Such as follicular NHL and mycosis fungoides.
Prognosis
The prognosis of NHL is related to the type of disease, the degree of invasion, clinical stage, molecular genetics, immunology and other factors.
At present, the International Prognostic Index (IPI) is often used in clinical work to judge the prognosis. It is suitable for various types of lymphoma, and the patients are divided into four groups with different risk levels according to their scores.
