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同一种病,结局大不同?“淋巴癌”常见信号有哪些?如何诊断?

2016-02-05 肿瘤专家何大夫 头条号

据报道,2015年6月著名表演艺术家、廖凡父亲廖丙炎被查出“非霍奇金淋巴瘤”,并进行多次化疗,就在廖老被确诊为恶性淋巴瘤后不久,著名人士李开复宣布:“经过17个月的积极配合治疗,自己的恶性淋巴瘤彻底治愈”。昨日,廖凡的经纪人证实,父亲廖丙炎已于上周六(1月9日)因淋巴癌过世。同一种病为什么有这么大的差异呢? 淋巴瘤分为两种类型:霍奇金淋巴瘤(HD)和非霍奇金淋巴瘤(NHL),前者预后极好,不用多

据报道,2015年6月著名表演艺术家、廖凡父亲廖丙炎被查出“非霍奇金淋巴瘤”,并进行多次化疗,就在廖老被确诊为恶性淋巴瘤后不久,著名人士李开复宣布:“经过17个月的积极配合治疗,自己的恶性淋巴瘤彻底治愈”。昨日,廖凡的经纪人证实,父亲廖丙炎已于上周六(1月9日)因淋巴癌过世。同一种病为什么有这么大的差异呢?

淋巴瘤分为两种类型:霍奇金淋巴瘤(HD)和非霍奇金淋巴瘤(NHL),前者预后极好,不用多谈。非霍奇金淋巴瘤的发展和扩散速度不同。惰性淋巴瘤往往生长和扩散缓慢,很少有明显症状和体征。侵袭性淋巴瘤的增长和迅速蔓延,并有迹象和逐渐加重的一些不适症状,病情恶化较快。当然,对于惰性和侵袭性淋巴瘤的治疗方法是不同的。同一种病,为什么结局大不同?恶性淋巴瘤的预后还取决于以下几个因素:
同一种病,结局大不同?“淋巴癌”常见信号有哪些?如何诊断?

①癌症发现时所处的阶段。早期阶段,经过合理治疗,容易取得满意疗效,晚期往往会有不良的预后;

②血液乳酸脱氢酶(LDH)的量。LDH增高与肿瘤负荷有关,为预后不良的重要指标。

③患者的年龄和平常一般健康状况。有年龄优势,平常健康状况良好者预后相对较好。

④刚刚被确诊的相对好治,复发的淋巴瘤就比较难治。

罹患非霍奇金淋巴瘤的常见危险因素:中老年男性;免疫系统功能降低(如HIV感染者);人T淋巴细胞病毒I型或EB病毒感染;幽门螺杆菌(HP)感染;器官移植后的免疫抑制剂的使用;家族肿瘤病史

非霍奇金淋巴瘤常见信号有哪些呢?颈部,腋窝,腹股沟(大腿根)肿胀或摸到肿块,或胃的淋巴结肿大;发热(原因不明);经常性盗汗;持续性疲劳(原因不明);消瘦(原因不明);皮疹或皮肤瘙痒;胸腹部疼痛(消化系统或骨骼没有查到原因)。特别注意:当发热,盗汗,体重减轻一并出现在一个人身上(这组症状被称为B症状),更要当心注意除外淋巴瘤。

如果出现上述相关信号,并且具备一个或几个危险因素,务必找医生咨询就诊,那么如果怀疑淋巴瘤,最终是如何诊断的呢?
同一种病,结局大不同?“淋巴癌”常见信号有哪些?如何诊断?

▓全血计数(CBC)计数:红血细胞,血小板,白血细胞的数量和类型。

▓影像学检查:胸腹部CT扫描、全身PET-CT扫描等。全身浅表淋巴结彩超。等等辅助检查。

▓淋巴结活检:所有的淋巴结切除或部分。病理学家通过在显微镜下的组织来寻找癌细胞。之一的活检以下类型的可以进行:切除活检:整个淋巴结的摘除;切取活检:切取淋巴结的一部分做细胞学检测。

骨髓穿刺和活检:将细针插入髋骨或胸骨,病理学家显微镜下寻找癌症的迹象。
同一种病,结局大不同?“淋巴癌”常见信号有哪些?如何诊断?

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  1. [GetPortalCommentsPageByObjectIdResponse(id=64017, encodeId=831f6401e11, content=原来如此, beContent=null, objectType=article, channel=null, level=null, likeNumber=211, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2cee1686934, createdName=1de4ac4em35(暂无匿称), createdTime=Thu Feb 11 21:45:00 CST 2016, time=2016-02-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1486585, encodeId=ad391486585eb, content=<a href='/topic/show?id=54d6659e194' target=_blank style='color:#2F92EE;'>#淋巴癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65971, encryptionId=54d6659e194, topicName=淋巴癌)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=90ec8173884, createdName=xinmeili, createdTime=Sun Feb 07 09:05:00 CST 2016, time=2016-02-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=63501, encodeId=3408635015c, content=是的, beContent=null, objectType=article, channel=null, level=null, likeNumber=170, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Sat Feb 06 12:07:00 CST 2016, time=2016-02-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=63460, encodeId=6f2563460a1, content=不过,据说李开复好像没有患淋巴癌,淋巴癌是假的。, beContent=null, objectType=article, channel=null, level=null, likeNumber=127, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c4a5105539, createdName=lovetcm, createdTime=Fri Feb 05 19:26:00 CST 2016, time=2016-02-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=63458, encodeId=bc55634581f, content=科普小常识非常好,这下终于懂得了,同样的疾病,差别非常非常之大。, beContent=null, objectType=article, channel=null, level=null, likeNumber=175, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c4a5105539, createdName=lovetcm, createdTime=Fri Feb 05 19:25:00 CST 2016, time=2016-02-05, status=1, ipAttribution=)]
    2016-02-11 1de4ac4em35(暂无匿称)

    原来如此

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=64017, encodeId=831f6401e11, content=原来如此, beContent=null, objectType=article, channel=null, level=null, likeNumber=211, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2cee1686934, createdName=1de4ac4em35(暂无匿称), createdTime=Thu Feb 11 21:45:00 CST 2016, time=2016-02-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1486585, encodeId=ad391486585eb, content=<a href='/topic/show?id=54d6659e194' target=_blank style='color:#2F92EE;'>#淋巴癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65971, encryptionId=54d6659e194, topicName=淋巴癌)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=90ec8173884, createdName=xinmeili, createdTime=Sun Feb 07 09:05:00 CST 2016, time=2016-02-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=63501, encodeId=3408635015c, content=是的, beContent=null, objectType=article, channel=null, level=null, likeNumber=170, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Sat Feb 06 12:07:00 CST 2016, time=2016-02-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=63460, encodeId=6f2563460a1, content=不过,据说李开复好像没有患淋巴癌,淋巴癌是假的。, beContent=null, objectType=article, channel=null, level=null, likeNumber=127, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c4a5105539, createdName=lovetcm, createdTime=Fri Feb 05 19:26:00 CST 2016, time=2016-02-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=63458, encodeId=bc55634581f, content=科普小常识非常好,这下终于懂得了,同样的疾病,差别非常非常之大。, beContent=null, objectType=article, channel=null, level=null, likeNumber=175, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c4a5105539, createdName=lovetcm, createdTime=Fri Feb 05 19:25:00 CST 2016, time=2016-02-05, status=1, ipAttribution=)]
  3. [GetPortalCommentsPageByObjectIdResponse(id=64017, encodeId=831f6401e11, content=原来如此, beContent=null, objectType=article, channel=null, level=null, likeNumber=211, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2cee1686934, createdName=1de4ac4em35(暂无匿称), createdTime=Thu Feb 11 21:45:00 CST 2016, time=2016-02-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1486585, encodeId=ad391486585eb, content=<a href='/topic/show?id=54d6659e194' target=_blank style='color:#2F92EE;'>#淋巴癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65971, encryptionId=54d6659e194, topicName=淋巴癌)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=90ec8173884, createdName=xinmeili, createdTime=Sun Feb 07 09:05:00 CST 2016, time=2016-02-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=63501, encodeId=3408635015c, content=是的, beContent=null, objectType=article, channel=null, level=null, likeNumber=170, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Sat Feb 06 12:07:00 CST 2016, time=2016-02-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=63460, encodeId=6f2563460a1, content=不过,据说李开复好像没有患淋巴癌,淋巴癌是假的。, beContent=null, objectType=article, channel=null, level=null, likeNumber=127, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c4a5105539, createdName=lovetcm, createdTime=Fri Feb 05 19:26:00 CST 2016, time=2016-02-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=63458, encodeId=bc55634581f, content=科普小常识非常好,这下终于懂得了,同样的疾病,差别非常非常之大。, beContent=null, objectType=article, channel=null, level=null, likeNumber=175, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c4a5105539, createdName=lovetcm, createdTime=Fri Feb 05 19:25:00 CST 2016, time=2016-02-05, status=1, ipAttribution=)]
    2016-02-06 忠诚向上

    是的

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=64017, encodeId=831f6401e11, content=原来如此, beContent=null, objectType=article, channel=null, level=null, likeNumber=211, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2cee1686934, createdName=1de4ac4em35(暂无匿称), createdTime=Thu Feb 11 21:45:00 CST 2016, time=2016-02-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1486585, encodeId=ad391486585eb, content=<a href='/topic/show?id=54d6659e194' target=_blank style='color:#2F92EE;'>#淋巴癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65971, encryptionId=54d6659e194, topicName=淋巴癌)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=90ec8173884, createdName=xinmeili, createdTime=Sun Feb 07 09:05:00 CST 2016, time=2016-02-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=63501, encodeId=3408635015c, content=是的, beContent=null, objectType=article, channel=null, level=null, likeNumber=170, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Sat Feb 06 12:07:00 CST 2016, time=2016-02-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=63460, encodeId=6f2563460a1, content=不过,据说李开复好像没有患淋巴癌,淋巴癌是假的。, beContent=null, objectType=article, channel=null, level=null, likeNumber=127, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c4a5105539, createdName=lovetcm, createdTime=Fri Feb 05 19:26:00 CST 2016, time=2016-02-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=63458, encodeId=bc55634581f, content=科普小常识非常好,这下终于懂得了,同样的疾病,差别非常非常之大。, beContent=null, objectType=article, channel=null, level=null, likeNumber=175, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c4a5105539, createdName=lovetcm, createdTime=Fri Feb 05 19:25:00 CST 2016, time=2016-02-05, status=1, ipAttribution=)]
    2016-02-05 lovetcm

    不过,据说李开复好像没有患淋巴癌,淋巴癌是假的。

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=64017, encodeId=831f6401e11, content=原来如此, beContent=null, objectType=article, channel=null, level=null, likeNumber=211, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2cee1686934, createdName=1de4ac4em35(暂无匿称), createdTime=Thu Feb 11 21:45:00 CST 2016, time=2016-02-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1486585, encodeId=ad391486585eb, content=<a href='/topic/show?id=54d6659e194' target=_blank style='color:#2F92EE;'>#淋巴癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65971, encryptionId=54d6659e194, topicName=淋巴癌)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=90ec8173884, createdName=xinmeili, createdTime=Sun Feb 07 09:05:00 CST 2016, time=2016-02-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=63501, encodeId=3408635015c, content=是的, beContent=null, objectType=article, channel=null, level=null, likeNumber=170, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Sat Feb 06 12:07:00 CST 2016, time=2016-02-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=63460, encodeId=6f2563460a1, content=不过,据说李开复好像没有患淋巴癌,淋巴癌是假的。, beContent=null, objectType=article, channel=null, level=null, likeNumber=127, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c4a5105539, createdName=lovetcm, createdTime=Fri Feb 05 19:26:00 CST 2016, time=2016-02-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=63458, encodeId=bc55634581f, content=科普小常识非常好,这下终于懂得了,同样的疾病,差别非常非常之大。, beContent=null, objectType=article, channel=null, level=null, likeNumber=175, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c4a5105539, createdName=lovetcm, createdTime=Fri Feb 05 19:25:00 CST 2016, time=2016-02-05, status=1, ipAttribution=)]
    2016-02-05 lovetcm

    科普小常识非常好,这下终于懂得了,同样的疾病,差别非常非常之大。

    0

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