Immunophenotypic and Clinical Differences Between the Nasal and Extranasal Subtypes of Upper Aerodigestive Tract Natural Killer/T-Cell Lymphoma

• Published in: International journal of radiation oncology, biology, physics Vol. 88; no. 4; pp. 806 - 813
• Main Authors: Liu, Qing-Feng, Wang, Wei-Hu, Wang, Shu-Lian, Liu, Yue-Ping, Huang, Wen-Ting, Lu, Ning, Zhou, Li-Qiang, Ouyang, Han, Jin, Jing, Li, Ye-Xiong
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 15.03.2014
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Antigens, Neoplasm - metabolism; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; CD56 Antigen - metabolism; Child; Cohort Studies; Cyclophosphamide - therapeutic use; DIAGNOSIS; Doxorubicin - analogs & derivatives; Doxorubicin - therapeutic use; Female; Hematology, Oncology and Palliative Medicine; Humans; Immunophenotyping - methods; Ki-67 Antigen - metabolism; Laryngeal Neoplasms - drug therapy; Laryngeal Neoplasms - immunology; Laryngeal Neoplasms - mortality; Laryngeal Neoplasms - pathology; LYMPH NODES; Lymphatic Metastasis; Lymphoma, Extranodal NK-T-Cell - drug therapy; Lymphoma, Extranodal NK-T-Cell - immunology; Lymphoma, Extranodal NK-T-Cell - mortality; Lymphoma, Extranodal NK-T-Cell - pathology; Lymphoma, T-Cell - drug therapy; Lymphoma, T-Cell - immunology; Lymphoma, T-Cell - mortality; Lymphoma, T-Cell - pathology; LYMPHOMAS; Male; Middle Aged; Neoplasm Staging; NOSE; Nose Neoplasms - drug therapy; Nose Neoplasms - immunology; Nose Neoplasms - mortality; Nose Neoplasms - pathology; PATIENTS; Pharyngeal Neoplasms - drug therapy; Pharyngeal Neoplasms - immunology; Pharyngeal Neoplasms - mortality; Pharyngeal Neoplasms - pathology; Prednisone - therapeutic use; Prognosis; Radiology; RADIOLOGY AND NUCLEAR MEDICINE; Retrospective Studies; Severity of Illness Index; Survival Rate; Tongue Neoplasms - drug therapy; Tongue Neoplasms - immunology; Tongue Neoplasms - mortality; Tongue Neoplasms - pathology; Tracheal Neoplasms - immunology; Tracheal Neoplasms - mortality; Tracheal Neoplasms - pathology; Vincristine - therapeutic use; Young Adult
• ISSN: 0360-3016; 1879-355X; 1879-355X
• DOI: 10.1016/j.ijrobp.2013.12.005

To investigate, in a large cohort of patients, the immunophenotypic and clinical differences of nasal and extranasal extranodal nasal-type natural killer/T-cell lymphoma of the upper aerodigestive tract (UADT-NKTCL) and examine the relevance of the immunophenotype on the clinical behavior, prognosis, and treatment. A total of 231 patients with UADT-NKTCL were recruited. One hundred eighty-one patients had primary location in the nasal cavity (nasal UADT-NKTCL), and 50 patients had primary extranasal UADT-NKTCL. Patients with extranasal UADT-NKTCL had more adverse clinical features, including advanced-stage disease, regional lymph node involvement, B symptoms, and poor performance status, than patients with nasal UADT-NKTCL. In addition, CD56 and granzyme B were less frequently expressed in extranasal UADT-NKTCL. The 5-year overall survival rate was 74.1% for the entire group and 76.0% for early-stage disease. The 5-year overall survival rate for extranasal UADT-NKTCL was similar or superior to that of nasal UADT-NKTCL for all disease stages (76.9% vs 73.4%, P=.465), stage I disease (75.9% vs 79.2%, P=.786), and stage II disease (83.3% vs 50.3%, P=.018). CD56 expression and a Ki-67 proliferation rate ≥50% predicted poorer survival for extranasal UADT-NKTCL but not for nasal UADT-NKTCL. Patients with nasal and extranasal UADT-NKTCL have significantly different clinical features, immunophenotypes, and prognosis. Extranasal UADT-NKTCL should be considered as a distinct subgroup apart from the most commonly diagnosed prototype of nasal UADT-NKTCL.