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style=\"font-size: 15px;\">弥漫大B细胞淋巴瘤（Diffuse Large B-Cell Lymphoma，DLBCL）是一种起源于B淋巴细胞的侵袭性非霍奇金淋巴瘤，也是成人最常见的淋巴瘤类型之一。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp>\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp>\u003Cspan style=\"font-size: 15px;\">DLBCL可以发生在任何年龄，但更常见于老年人。疾病通常进展较快，可发生于淋巴结，也可以发生在胃肠道、中枢神经系统、骨、皮肤等淋巴结以外的部位。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp>\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp>\u003Cspan style=\"font-size: 15px;\">DLBCL并不是单一疾病。根据肿瘤细胞的形态、免疫表型、遗传和分子特征等，可以进一步分为不同类型。明确这些特征对于判断疾病风险和选择治疗方案具有重要意义。\u003C\u002Fspan>\u003C\u002Fp>","⚕️","2026-09-14",{"key":90,"title":91,"html":92,"icon":93,"updatedAt":88},"cause","病因","\u003Cdiv>\u003Cspan style=\"font-size: 15px;\"> 弥漫大B细胞淋巴瘤（DLBCL）通常为原发性，但也可由相对惰性的淋巴瘤，如慢性淋巴细胞白血病\u002F小淋巴细胞淋巴瘤、滤泡淋巴瘤发展或转化而来。\u003C\u002Fspan>\u003C\u002Fdiv>\u003Cdiv>\u003Cbr\u002F>\u003C\u002Fdiv>\u003Cdiv>\u003Cspan style=\"font-size: 15px;\">DLBCL的病因尚不知。免疫缺陷是重要的危险因素，在免疫缺陷的患者中，EB病毒阳性的患者显著多于无明显免疫缺陷者，可能与DLBCL的发病有关。\u003C\u002Fspan>\u003C\u002Fdiv>","🧬",{"key":95,"title":96,"html":97,"icon":98,"updatedAt":88},"symptom","症状表现","\u003Cp>\u003Cspan style=\"font-size: 15px;\"> 弥漫大B细胞淋巴瘤（DLBCL）的症状与体征包括：\u003C\u002Fspan>\u003C\u002Fp>\u003Cp>\u003Cbr\u002F>\u003C\u002Fp>\u003Cp>\u003Cspan style=\"font-size: 15px;\">1、无痛性、进行性淋巴结肿大和淋巴结外的肿块，为典型的DLBCL表现。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp>\u003Cbr\u002F>\u003C\u002Fp>\u003Cp>\u003Cspan style=\"font-size: 15px;\">2、常伴有发热、乏力和盗汗（B症状）。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp>\u003Cbr\u002F>\u003C\u002Fp>\u003Cdiv>\u003Cspan style=\"font-size: 15px;\">3、40%的肿瘤原发于淋巴结外，最常见的部位是胃肠道（胃和回盲部），其他部位也常有发生，但原发于骨髓和（或）直接累及血液者较少见。由于肿块生长迅速，肿块可在相应部位引起压迫症状，随着病情的发展常常发生扩散。\u003C\u002Fspan>\u003C\u002Fdiv>\u003Cdiv>\u003Cbr\u002F>\u003C\u002Fdiv>","📋",{"key":100,"title":101,"html":102,"icon":103,"updatedAt":88},"exam","检查方式","\u003Cp>\u003Cspan style=\"font-size: 15px;\"> 如果医生怀疑您患有弥漫大B细胞淋巴瘤（DLBCL），他（她）首先会对您做全面的体格检查。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp>\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp>\u003Cstrong>\u003Cspan style=\"font-size: 15px;\">诊断弥漫大B细胞淋巴瘤的常规检查包括：\u003C\u002Fspan>\u003C\u002Fstrong>\u003C\u002Fp>\u003Cp>\u003Cstrong>\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fstrong>\u003C\u002Fp>\u003Cul class=\" list-paddingleft-2\" style=\"list-style-type: disc;\">\u003Cli>\u003Cdiv>\u003Cspan style=\"font-size: 15px;\">血液检查：用于观察不同类型血细胞的数量和形态。\u003C\u002Fspan>\u003C\u002Fdiv>\u003Cdiv>\u003Cspan style=\"font-size: 15px;\">\u003C\u002Fspan>\u003C\u002Fdiv>\u003Cdiv>\u003Cspan style=\"font-size: 15px;\">\u003C\u002Fspan>\u003C\u002Fdiv>\u003C\u002Fli>\u003Cli>\u003Cdiv>\u003Cspan style=\"font-size: 15px;\">骨髓检查：用于观察骨骼内的造血组织。进行骨髓穿刺时，医生会用一根穿刺针抽取骨髓标本，通常是从髋骨部位(髂后上棘)取骨髓标本，这些标本会被送至实验室进行检查。\u003C\u002Fspan>\u003C\u002Fdiv>\u003C\u002Fli>\u003Cli>\u003Cdiv>\u003Cspan style=\"font-size: 15px;\">胸部X线检查：用于观察肺部及其周围区域的情况。\u003C\u002Fspan>\u003C\u002Fdiv>\u003C\u002Fli>\u003Cli>\u003Cdiv>\u003Cspan style=\"font-size: 15px;\">CT检查：用于观察身体各部位的横截面图像。您可能需要接受胸部、腹部和（或）盆腔部位的扫描。\u003C\u002Fspan>\u003C\u002Fdiv>\u003C\u002Fli>\u003Cli>\u003Cdiv>\u003Cspan style=\"font-size: 15px;\">PET\u002FCT检查：使用特殊的摄像机和放射性示踪剂，灵敏、准确地了解患者全身整体状况。\u003C\u002Fspan>\u003C\u002Fdiv>\u003C\u002Fli>\u003Cli>\u003Cdiv>\u003Cspan style=\"font-size: 15px;\">流式细胞分析：可检测细胞表面的蛋白，其检查结果可对免疫组化的方法进行补充。\u003C\u002Fspan>\u003C\u002Fdiv>\u003C\u002Fli>\u003Cli>\u003Cdiv>\u003Cspan style=\"font-size: 15px;\">基因检测：用于检查DLBCL常见的染色体和基因异常，利用细胞学方法可发现染色体数量或结构异常。\u003C\u002Fspan>\u003C\u002Fdiv>\u003C\u002Fli>\u003C\u002Ful>","🩺",{"key":105,"title":106,"html":107,"icon":108,"updatedAt":88},"treatment","治疗方式","\u003Cp>\u003Cspan style=\"font-size: 15px;\">\u003Cstrong> 化疗：是一种通过口服或注射给药来杀灭癌细胞的药物治疗。化疗药物可以单独使用，也可以与其他化疗药物或其他治疗方法联用。\u003C\u002Fstrong>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp>\u003Cbr\u002F>\u003C\u002Fp>\u003Cdiv>\u003Cspan style=\"font-size: 15px;\">化疗通常是DLBCL的首选治疗方法，即使不把化疗作为首选治疗，在其他治疗手段无效时，同样可以选择化疗。\u003C\u002Fspan>\u003C\u002Fdiv>\u003Cdiv>\u003Cbr\u002F>\u003C\u002Fdiv>\u003Cdiv>\u003Cspan style=\"font-size: 15px;\">化疗的副作用取决于患者使用的化疗药物。常见的副作用包括恶心和脱发，患者也有可能出现远期的并发症如心脏损伤、肺损伤、生育问题和其他癌症（如白血病）。\u003C\u002Fspan>\u003C\u002Fdiv>\u003Cdiv>\u003Cbr\u002F>\u003C\u002Fdiv>\u003Cp>\u003Cspan style=\"font-size: 15px;\">\u003Cstrong>放疗：利用高能射线治疗肿瘤，可单独使用，也可与其他癌症治疗方法联用。\u003C\u002Fstrong>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp>\u003Cbr\u002F>\u003C\u002Fp>\u003Cp>\u003Cspan style=\"font-size: 15px;\">放疗过程中，患者要躺在治疗台上，一台大型机器会围绕患者转动，将高能射线精准照射到治疗部位（如受累的淋巴结及附近可能受侵犯的区域）。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp>\u003Cbr\u002F>\u003C\u002Fp>\u003Cdiv>\u003Cspan style=\"font-size: 15px;\">放疗可引起治疗部位的皮肤发红和脱发，很多患者在治疗中会感到疲劳；更严重的风险包括心脏疾病、卒中、甲状腺疾病、不孕不育和其他癌症（如乳腺癌或肺癌）。\u003C\u002Fspan>\u003C\u002Fdiv>\u003Cdiv>\u003Cbr\u002F>\u003C\u002Fdiv>\u003Cdiv>\u003Cspan style=\"font-size: 15px;\">\u003Cstrong>靶向药物：\u003C\u002Fstrong>靶向药物利妥昔单抗是一种单克隆抗体，它能够和B细胞结合，使免疫系统更容易识别B细胞并将其清除。使用利妥昔单抗会使B细胞数量减少，其中也包括健康的B细胞，但人体可以产生新的正常B细胞来补充，不太可能出现恶性B细胞。\u003C\u002Fspan>\u003C\u002Fdiv>\u003Cdiv>\u003Cbr\u002F>\u003C\u002Fdiv>\u003Cdiv>\u003Cspan style=\"font-size: 15px;\">\u003Cstrong>细胞免疫治疗：\u003C\u002Fstrong>是通过体外诱导激活、扩增自体或异体的免疫效应细胞，之后回输入患者体内，进而杀伤肿瘤细胞、提高患者抗肿瘤免疫功能，目前已经成为包括恶性血液病在内的多种肿瘤的重要治疗手段。\u003C\u002Fspan>\u003C\u002Fdiv>\u003Cdiv>\u003Cspan style=\"font-size: 15px;\">近几年，CAR-T细胞疗法治疗难治、复发性DLBCL获得了较好的效果。\u003C\u002Fspan>\u003C\u002Fdiv>\u003Cdiv>\u003Cbr\u002F>\u003C\u002Fdiv>\u003Cdiv>\u003Cspan style=\"font-size: 15px;\">\u003Cstrong>造血干细胞移植：\u003C\u002Fstrong>医生会先利用大剂量的化疗和放疗来抑制骨髓，随后将从患者自身或供者身上采集的健康骨髓干细胞输入患者的血液中，干细胞会随血液循环进入骨骼并重建骨髓。\u003C\u002Fspan>\u003C\u002Fdiv>\u003Cdiv>\u003Cbr\u002F>\u003C\u002Fdiv>\u003Cdiv>\u003Cspan style=\"font-size: 15px;\">\u003Cstrong>临床试验：\u003C\u002Fstrong>对于其他治疗方案无法控制病情的患者，可以选择参与临床研究（临床试验），请向医生咨询是否有与您的非霍奇金淋巴瘤类型相关的临床试验。\u003C\u002Fspan>\u003C\u002Fdiv>","💊",{"author":110,"reviewedBy":110,"lastReviewed":110,"datePublished":110,"citations":111,"disclaimer":110},"",[112],{"title":113},"Mayo Clinic",false,1789384106318]