text stringlengths 4 4.87k | entities list |
|---|---|
考虑到后尿道瓣膜即应进行排尿性膀胱尿道造影（VCUG）。 | [
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"entity": "VCUG",
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在胎儿中，羊水量减少是下尿路存在梗阻的一个重要信号。 | [
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对胎儿期即出现双侧肾积水的新生儿出生后均要进一步做超声检查和VCUG以尽早确诊后尿道瓣膜。 | [
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"entity": "后尿道瓣膜",
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【治疗】后尿道瓣膜一旦确诊即应保留导尿管，解除下尿路梗阻。 | [
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"entity": "保留导尿管",
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"entity": "解除下尿路梗阻",
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先纠正水、电解质失衡，控制感染，随后进行经尿道膀胱镜瓣膜电灼。 | [
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在比较偏远、交通不发达、又无电切设备的地区，或患儿小、膀胱镜无法进入时可进行膀胱造瘘。 | [
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"entity": "膀胱镜无法进入时可进行膀胱造瘘",
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但采用不置造瘘管的膀胱皮肤造口术，护理上简单。 | [
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部分患儿，因膀胱功能损害严重，瓣膜电切后，仍无法排尿；或肾功能及代谢功能未能改善，也可进行膀胱造瘘。 | [
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对后尿道瓣膜的胎儿进行宫内手术，主要是膀胱造瘘以减压的问题目前有很大的争议，其对母亲和胎儿的影响、所能达到的效果以及并发症的发生情况都在观察之中。 | [
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【预后】后尿道瓣膜的预后并不令人乐观，尤其是新生儿期即出现症状的患儿。 | [
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我们在临床上常常看到瓣膜电灼后尿路梗阻已解除，但膀胱内始终有残余尿，肾输尿管积水没有改善或反而恶化，出现肾衰竭的情况。 | [
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"entity": "膀胱",
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"id": 3,
"entity": "尿",
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"entity": "肾输尿管积水",
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"entity": "肾衰竭",
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因此瓣膜电灼后应定期随访，观察膀胱排空，有无反复泌尿系感染及肾功能恢复情况。 | [
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"entity": "反复泌尿系感染",
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对膀胱输尿管反流，我们一般要在电灼瓣膜后6～12个月以上才考虑手术治疗。 | [
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对膀胱功能异常，如排尿困难或尿失禁等，要依据膀胱的肌肉收缩状况、膀胱容量以及顺应性分别予以处理。 | [
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"entity": "膀胱容量",
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可相应地用抗胆碱类药物治疗、间歇性清洁导尿或膀胱扩大术以改善症状。 | [
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第十七节包茎新生儿出生后在正常情况下其阴茎头完全被包皮覆盖，并且阴茎头和包皮之间存在粘连。 | [
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随着阴茎和阴茎头的发育，以及所产生的分泌物在其间的积聚，粘连的逐渐吸收，加之阴茎勃起的作用，包皮与阴茎头逐渐分离，国外报告在3岁左右，包皮可上翻，阴茎头得以显露。 | [
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"entity": "阴茎头",
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如果没有排尿困难及没有阴茎头包皮炎，我们认为学龄前儿童包皮覆盖阴茎头，即包皮过长，是正常的生理现象，不必做任何处理。 | [
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"entity": "包皮过长",
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对包茎的定义，我们认为应是在学龄期后包皮口仍狭小，包皮不能翻转显露阴茎头。 | [
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但包茎是否一定要手术，尚存争议。 | [
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美国对阴茎发育的调查显示，3岁时有90%的包茎自愈；17岁以后，包茎不足1%，因此包皮由不能上翻至完全上翻是一个逐渐发展的过程。 | [
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"id": 1,
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"id": 2,
"entity": "包茎",
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{
"id": 3,
"entity": "包皮",
"start_offset": 41,
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"label": "bod"
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美国及加拿大的儿科学会已不提倡新生儿包皮环切，当然在有膀胱输尿管反流的情况下另当别论。 | [
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嵌顿包茎是包茎的并发症。 | [
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由于包皮口狭小，当包皮被上翻至阴茎头冠状沟上方而又未及时复位后，狭窄的包皮环将阻塞其远端阴茎、尤其是阴茎头的静脉及淋巴回流引起其水肿，反使包皮更不能复原，造成嵌顿包茎待包皮水肿后，包皮狭窄环越来越紧，以至循环阻塞及水肿更加严重，形成恶性循环。 | [
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"entity": "阴茎",
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"entity": "阴茎头",
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"entity": "静脉",
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"entity": "淋巴",
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"entity": "当包皮被上翻至阴茎头冠状沟上方而又未及时复位后，狭窄的包皮环将阻塞其远端阴茎、尤其是阴茎头的静脉及淋巴回流",
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"entity": "引起其水肿",
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"entity": "嵌顿包茎",
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"id": 12,
"entity": "反使包皮更不能复原，造成嵌顿包茎",
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},
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"id": 13,
"entity": "包皮",
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{
"id": 14,
"entity": "包皮",
"start_offset": 90,
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},
{
"id": 15,
"entity": "待包皮水肿后，包皮狭窄环越来越紧",
"start_offset": 83,
"end_offset": 99,
"label": "sym"
},
{
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"entity": "以至循环阻塞及水肿更加严重，形成恶性循环",
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临床表现为水肿的包皮翻在阴茎头的冠状沟上方，在水肿的包皮上缘可见到狭窄环，阴茎头呈暗紫色肿大。 | [
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"entity": "在水肿的包皮上缘可见到狭窄环",
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"entity": "阴茎头",
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"id": 3,
"entity": "阴茎头呈暗紫色肿大",
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患儿疼痛剧烈，哭闹不止，可有排尿困难。 | [
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时间过长，嵌顿包皮及阴茎头可发生坏死、脱落。 | [
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嵌顿包茎应急诊处理，大部分患儿可手法复位。 | [
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如手法复位失败，要做包皮背侧切开术。 | [
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第二节儿童非霍奇金淋巴瘤儿童非霍奇金淋巴瘤（non-Hodgkinlymphomas，NHL）是源于免疫系统器官和细胞的一系列疾病的总称，包括所有未归类于霍奇金病的恶性淋巴瘤。 | [
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儿童NHL的现代治疗策略与儿童急性淋巴细胞性白血病（acutelymphoblasticleukemia，ALL）的治疗极其类似。 | [
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此外，免疫系统细胞具多样性，细胞分化为不同功能的多种细胞，以履行各种机体防御的职责。 | [
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细胞恶变可发生在这些功能截然不同的细胞及其前体细胞之中，因此，儿童NHL的形态学特征、免疫学特征及临床表现均呈现出多样化。 | [
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组织病理学、免疫学、细胞学及分子生物学的发展已极大地推动了我们对NHL生物学的理解，对正常及恶性淋巴细胞行为学和分子学基础研究的进步也使这些疾病得到了更合理的划分。 | [
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同时对恶性淋巴瘤的研究也充分增进了我们对正常淋巴细胞发育的认识。 | [
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值得注意的是，疗效的明显进步并非源自新型有效药物的开发，而是基于对NHL生物学、免疫学及分子生物学更深刻认知的、更合理的分类系统和相适应的治疗方案的进步和支持治疗的进展。 | [
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【流行病学及发病机制】儿童淋巴瘤的发病率依年龄不同，在世界不同地区也有显著差异。 | [
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10岁以下的儿童中NHL比霍奇金病更为常见，但霍奇金病的相对发病率在大于10岁的儿童中迅速上升。 | [
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此外，特定组织学亚型发病率与年龄有关，如Burkitt及Burkitt样淋巴瘤在5～15岁儿童中多见，而淋巴母细胞性淋巴瘤（lymphoblasticlymphoma，LL）的发病率则在各年龄组中比较恒定。 | [
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弥漫性大B细胞淋巴瘤（diffuselargeB-celllymphoma，DLBCL）是一种好发于大龄青少年的疾病，其发病率在整个童年期稳步上升，并在15～19岁年龄组内作为主导地位的组织学亚型达到高峰。 | [
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不同亚型NHL的发病率和相对频率在世界各个地区也有很大差异。 | [
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2002～2005年上海市肿瘤登记系统统计结果表明上海市0～14岁组儿童淋巴瘤年发病率为9.9/100万，在儿童肿瘤中占第三位，仅次于白血病和颅内肿瘤，其中近80%为NHL。 | [
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NHL的病因尚不明确。 | [
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经流行病学研究评估，迄今为止产前及产后的暴露研究并未发现各种暴露与患淋巴瘤风险增加明确相关。 | [
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遗传或获得性免疫缺陷综合征或接受免疫抑制治疗的病人中，NHL的发病率增高。 | [
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在Burkitt淋巴瘤中，免疫球蛋白基因正常重排程序发生错误，并通过易位导致c-myc基因的功能失调，使细胞的增殖与分化失衡，最终细胞发生癌变。 | [
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【病理分类】NHL为一组复杂疾病，无论从细胞形态学、临床表现、免疫表型，还是最近的细胞遗传学/分子生物学均有差异较大的变异。 | [
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值得注意的是，儿童NHL免疫表型特征与在儿童ALL有明显不同，后者约85%病例为早前B细胞免疫表型，15%源自T细胞，而仅有不到2%的病例是表达表面免疫球蛋白的成熟B细胞表型。 | [
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纵观所有淋巴系肿瘤，似乎早期B系来源淋巴肿瘤常起源于骨髓，临床上表现为ALL；而T细胞及成熟B细胞肿瘤分别源于胸腺和肠道淋巴组织的生发中心，较前者更可能起源于髓外部位，临床上则表现为NHL为多。 | [
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大细胞淋巴瘤从形态学和免疫学上均表现有异质性。 | [
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约1/3的儿童大细胞淋巴瘤为B细胞肿瘤；1/3为T细胞来源，且通常表达胸腺后“激活”T细胞的抗原谱；另30%则来自不确定的谱系（非T、非B）。 | [
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极少数病例来自组织细胞/巨噬细胞系，此类可被称为“真性组织细胞淋巴瘤”（表11-11）。 | [
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表11-15儿童NHL组织病理学、免疫表型、临床特征、细胞遗传学及分子学特征之间的关系以欧洲/美国主导的REAL淋巴肿瘤分类法（REALclassification）将免疫学、分子遗传学及标准形态学结合，并由此形成了WHO造血系统及淋巴肿瘤分类法的基石。 | [
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由此而来的WHO分类法将源自前体（淋巴母）淋巴细胞到成熟淋巴细胞各阶段起源淋巴系肿瘤ALL和NHL均包括在内，基于免疫表型谱（B细胞或T细胞/自然杀伤细胞肿瘤）进一步分类。 | [
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这一分类系统体现了淋巴细胞在不同成熟阶段恶变所形成的NHL和ALL自特定的临床、形态学、免疫学、遗传学特征。 | [
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根据WHO2008分类标准，儿童NHL主要有四个重要类型：成熟B细胞肿瘤（包括Burkitt淋巴瘤/成熟B细胞性白血病、未能进一步分类的B细胞淋巴瘤、弥漫大B细胞淋巴瘤及纵隔大B细胞淋巴瘤亚型），成熟（或周围）T细胞及自然杀伤细胞肿瘤（包括ALCL、CD30</sub>+</sup>、T细胞及裸细胞型），前B细胞肿瘤（包括前体B淋巴母细胞白血病/淋巴瘤），以及前T细胞肿瘤（包括前体T淋巴母细胞白血病/淋巴瘤）。 | [
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（一）Burkitt淋巴瘤Burkitt淋巴瘤在显微镜下肿瘤细胞弥漫性浸润，细胞小，含圆或卵圆形细胞核、1～3个强嗜碱性核仁，以及常含有脂泡的嗜碱性胞质。 | [
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}
] |
零散的残余正常巨噬细胞散布于恶性细胞之间，呈现特征性的“星空”貌。 | [
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{
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"entity": "恶性细胞",
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"label": "bod"
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] |
从免疫学上来说，Burkitt淋巴瘤及其变异型是生发中心B细胞肿瘤，细胞膜表达κ或λ轻链相关的表面免疫球蛋白（常为IgM），并可表达B系相关抗原CD19</sub>、CD20</sub>、CD22</sub>、CD79</sub>a及CD10</sub>，但常不表达末端脱氧核苷酸转移酶（TdT），是否表达TdT有助于鉴别Burkitt淋巴瘤与LL。 | [
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"entity": "Burkitt淋巴瘤",
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{
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{
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{
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{
"id": 8,
"entity": "CD79",
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{
"id": 9,
"entity": "CD10",
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"end_offset": 121,
"label": "bod"
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{
"id": 10,
"entity": "末端脱氧核苷酸转移酶",
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{
"id": 11,
"entity": "TdT",
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"id": 12,
"entity": "TdT",
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"end_offset": 156,
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{
"id": 13,
"entity": "Burkitt淋巴瘤",
"start_offset": 161,
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"label": "dis"
},
{
"id": 14,
"entity": "LL",
"start_offset": 172,
"end_offset": 174,
"label": "dis"
}
] |
1%～2%ALL患者有Burkitt淋巴瘤的形态学及免疫学特征（即FAB形态学分类中的L3型），常伴有腹部或其余部位的包块性疾病极晚期Burkitt淋巴瘤，对这类患儿应采用晚期Burkitt淋巴瘤的治疗方案。 | [
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{
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{
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"entity": "晚期Burkitt淋巴瘤",
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"label": "dis"
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] |
另两种变异易位可在15%的Burkitt淋巴瘤病例中观察到，包括t（2；8）（p-11.1；q24.1）及t（8；22）（q24.1；q11.2）。 | [
{
"id": 0,
"entity": "Burkitt淋巴瘤",
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"label": "dis"
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] |
（二）间变性大细胞淋巴瘤间变性大细胞淋巴瘤（ALCL）是儿童大细胞淋巴瘤中最常见的亚型，绝大多数归于成熟T细胞和自然杀伤细胞肿瘤。 | [
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"entity": "间变性大细胞淋巴瘤",
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{
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"entity": "成熟T细胞和自然杀伤细胞肿瘤",
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"end_offset": 64,
"label": "dis"
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] |
组织学常表现为凝聚性的、奇形怪状的、含丰富胞质的多型性大细胞，包含形状怪异的马蹄形细胞核ALCL表达T细胞抗原。 | [
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"id": 0,
"entity": "细胞核",
"start_offset": 41,
"end_offset": 44,
"label": "bod"
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{
"id": 1,
"entity": "含形状怪异的马蹄形细胞核",
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"id": 2,
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{
"id": 3,
"entity": "T细胞抗原",
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"label": "bod"
}
] |
该类肿瘤细胞也表达上皮细胞膜抗原（epithelialmembraneantigen，EMA）和CD30（Ki-1）抗原ALCL常存在特征性非随机染色体［t（2；5）（p23；q35）］平衡易位，染色体5q35位上的核磷蛋白基因NPM，与染色体2p23位上的间变性淋巴瘤激酶（anaplasticlymphomakinase，ALK），一种酪氨酸激酶基因融合。 | [
{
"id": 0,
"entity": "肿瘤细胞",
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},
{
"id": 1,
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{
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"id": 5,
"entity": "Ki-1",
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{
"id": 6,
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{
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"entity": "染色体",
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{
"id": 8,
"entity": "染色体5q",
"start_offset": 98,
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{
"id": 9,
"entity": "核磷蛋白基因NPM",
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{
"id": 10,
"entity": "染色体",
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{
"id": 11,
"entity": "间变性淋巴瘤激酶",
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{
"id": 12,
"entity": "anaplasticlymphomakinase",
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{
"id": 13,
"entity": "ALK",
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"end_offset": 166,
"label": "bod"
},
{
"id": 14,
"entity": "酪氨酸激酶基因",
"start_offset": 170,
"end_offset": 177,
"label": "bod"
}
] |
（三）淋巴母细胞白血病/淋巴瘤WHO将前驱T或B淋巴母细胞型白血病/淋巴瘤归为同一类，前驱T细胞起源者以淋巴瘤为多见，而前驱B细胞起源者以白血病多见。 | [
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"id": 0,
"entity": "淋巴母细胞白血病",
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"entity": "淋巴瘤",
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"entity": "T或B淋巴母细胞型白血病",
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{
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"entity": "淋巴瘤",
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"entity": "前驱T细胞",
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"entity": "淋巴瘤",
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"entity": "前驱B细胞",
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{
"id": 7,
"entity": "白血病",
"start_offset": 69,
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"label": "dis"
}
] |
T系相关抗原表达通常包括UCHL1（CD45RO）、CD1</sub>、CD2</sub>、CD3</sub>、CD4</sub>、CD5</sub>、CD7</sub>、CD8</sub>、CD56</sub>；B系表达CD19</sub>、CD20</sub>、CD22</sub>、CD79</sub>a及CD10</sub>，类似B系白血病，不表达细胞膜表达κ或λ轻链相关的表面免疫球蛋白（常为IgM）。 | [
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"entity": "抗原",
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{
"id": 1,
"entity": "UCHL1",
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{
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"entity": "CD45RO",
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{
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{
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{
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{
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},
{
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"entity": "CD5",
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},
{
"id": 8,
"entity": "CD7",
"start_offset": 76,
"end_offset": 79,
"label": "bod"
},
{
"id": 9,
"entity": "CD8",
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"end_offset": 89,
"label": "bod"
},
{
"id": 10,
"entity": "CD56",
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"end_offset": 100,
"label": "bod"
},
{
"id": 11,
"entity": "CD19",
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"end_offset": 115,
"label": "bod"
},
{
"id": 12,
"entity": "CD20",
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"label": "bod"
},
{
"id": 13,
"entity": "CD22",
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"end_offset": 137,
"label": "bod"
},
{
"id": 14,
"entity": "CD79",
"start_offset": 144,
"end_offset": 148,
"label": "bod"
},
{
"id": 15,
"entity": "CD10",
"start_offset": 156,
"end_offset": 160,
"label": "bod"
},
{
"id": 16,
"entity": "B系白血病",
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"label": "dis"
},
{
"id": 17,
"entity": "细胞膜",
"start_offset": 178,
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"label": "bod"
},
{
"id": 18,
"entity": "表面免疫球蛋白",
"start_offset": 191,
"end_offset": 198,
"label": "bod"
},
{
"id": 19,
"entity": "IgM",
"start_offset": 201,
"end_offset": 204,
"label": "bod"
}
] |
前驱T和B淋巴细胞均表达TdT。 | [
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"entity": "前驱T和B淋巴细胞",
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"label": "bod"
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{
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"entity": "TdT",
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] |
【临床表现】NHL临床表现差异大，一些病人仅有外周淋巴结无痛性肿大几乎无全身症状，因此在活检后即明确诊断。 | [
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{
"id": 1,
"entity": "淋巴结",
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{
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"entity": "外周淋巴结无痛性肿大",
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"label": "sym"
},
{
"id": 3,
"entity": "几乎无全身症状",
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"label": "sym"
},
{
"id": 4,
"entity": "活检",
"start_offset": 44,
"end_offset": 46,
"label": "pro"
}
] |
常见表现有非特异性全身症状，如发热，浅表淋巴结肿大盗汗。 | [
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"id": 0,
"entity": "非特异性全身症状",
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{
"id": 1,
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},
{
"id": 4,
"entity": "盗汗",
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] |
晚期病人出现消瘦、贫血、出血倾向、发热、肝脾大、浆膜腔积液恶病质等症状和体征。 | [
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"entity": "消瘦",
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{
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{
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{
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{
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{
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},
{
"id": 8,
"entity": "恶病质",
"start_offset": 29,
"end_offset": 32,
"label": "sym"
}
] |
1.淋巴母细胞型淋巴瘤原发于纵隔较为多见（70%为前T细胞性），肿块常位于前或中纵隔，巨大肿块可压迫气管、上腔静脉、心脏和肺，有时还合并大量胸水，临床出现胸痛刺激性咳嗽、气促、平卧困难，重者有呼吸困难、发绀、颈头面部及上肢水肿上腔静脉压迫综合征。 | [
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"id": 0,
"entity": "淋巴母细胞型淋巴瘤",
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{
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{
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{
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{
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},
{
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{
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"entity": "上腔静脉",
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"label": "bod"
},
{
"id": 7,
"entity": "心脏",
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"end_offset": 60,
"label": "bod"
},
{
"id": 8,
"entity": "肺",
"start_offset": 61,
"end_offset": 62,
"label": "bod"
},
{
"id": 9,
"entity": "胸水",
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"end_offset": 72,
"label": "bod"
},
{
"id": 10,
"entity": "胸",
"start_offset": 77,
"end_offset": 78,
"label": "bod"
},
{
"id": 11,
"entity": "胸痛",
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"end_offset": 79,
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},
{
"id": 12,
"entity": "刺激性咳嗽",
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"label": "sym"
},
{
"id": 13,
"entity": "气促",
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"label": "sym"
},
{
"id": 14,
"entity": "平卧困难",
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"label": "sym"
},
{
"id": 15,
"entity": "呼吸困难",
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"end_offset": 100,
"label": "sym"
},
{
"id": 16,
"entity": "发绀",
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"label": "sym"
},
{
"id": 17,
"entity": "颈",
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"end_offset": 105,
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},
{
"id": 18,
"entity": "头",
"start_offset": 105,
"end_offset": 106,
"label": "bod"
},
{
"id": 19,
"entity": "颈头面部及上肢水肿",
"start_offset": 104,
"end_offset": 113,
"label": "sym"
},
{
"id": 20,
"entity": "上腔静脉压迫综合征",
"start_offset": 113,
"end_offset": 122,
"label": "dis"
}
] |
胸部X线平片可见中、前纵隔巨大肿块可伴有不等量胸水伯基特型淋巴瘤原发于腹部较为多见（成熟B细胞性，Burkitt），可有腹痛、腹围增大、恶心、呕吐、大便习惯改变、肝脾肿大、腹水。 | [
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"entity": "胸部X线平片",
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"label": "pro"
},
{
"id": 1,
"entity": "中、前纵隔",
"start_offset": 8,
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"label": "bod"
},
{
"id": 2,
"entity": "中、前纵隔巨大肿块",
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"label": "sym"
},
{
"id": 3,
"entity": "胸水",
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},
{
"id": 4,
"entity": "可伴有不等量胸水",
"start_offset": 17,
"end_offset": 25,
"label": "sym"
},
{
"id": 5,
"entity": "伯基特型淋巴瘤",
"start_offset": 25,
"end_offset": 32,
"label": "dis"
},
{
"id": 6,
"entity": "腹部",
"start_offset": 35,
"end_offset": 37,
"label": "bod"
},
{
"id": 7,
"entity": "有腹痛",
"start_offset": 59,
"end_offset": 62,
"label": "sym"
},
{
"id": 8,
"entity": "腹围增大",
"start_offset": 63,
"end_offset": 67,
"label": "sym"
},
{
"id": 9,
"entity": "恶心",
"start_offset": 68,
"end_offset": 70,
"label": "sym"
},
{
"id": 10,
"entity": "呕吐",
"start_offset": 71,
"end_offset": 73,
"label": "sym"
},
{
"id": 11,
"entity": "大便习惯改变",
"start_offset": 74,
"end_offset": 80,
"label": "sym"
},
{
"id": 12,
"entity": "肝脾肿大",
"start_offset": 81,
"end_offset": 85,
"label": "sym"
},
{
"id": 13,
"entity": "腹水",
"start_offset": 86,
"end_offset": 88,
"label": "sym"
}
] |
3.大细胞型淋巴瘤70%大细胞型淋巴瘤来源于T细胞性，20%～30%为B细胞性，尚有部分病人来源于NK细胞或不表达T或B细胞标记的裸细胞。 | [
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"id": 0,
"entity": "大细胞型淋巴瘤",
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"label": "dis"
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{
"id": 1,
"entity": "大细胞型淋巴瘤",
"start_offset": 12,
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},
{
"id": 2,
"entity": "NK细胞",
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"end_offset": 53,
"label": "bod"
},
{
"id": 3,
"entity": "T或B细胞",
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"label": "bod"
},
{
"id": 4,
"entity": "裸细胞",
"start_offset": 65,
"end_offset": 68,
"label": "bod"
}
] |
大细胞型NHL临床表现相对复杂，病程相对较长，可有较特殊部位的浸润，如原发于皮肤皮下组织、中枢神经系统、肺、睾丸、骨甚至肌肉等。 | [
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"id": 0,
"entity": "大细胞型NHL",
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"label": "dis"
},
{
"id": 1,
"entity": "皮肤皮下组织",
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"end_offset": 44,
"label": "bod"
},
{
"id": 2,
"entity": "中枢神经系统",
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"label": "bod"
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{
"id": 3,
"entity": "肺",
"start_offset": 52,
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{
"id": 4,
"entity": "睾丸",
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"end_offset": 56,
"label": "bod"
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{
"id": 5,
"entity": "骨",
"start_offset": 57,
"end_offset": 58,
"label": "bod"
},
{
"id": 6,
"entity": "肌肉",
"start_offset": 60,
"end_offset": 62,
"label": "bod"
}
] |
儿童NHL可在诊断时和病程中出现中枢神经系统浸润，并有相应症状与体征，各型NHL均可发生，与骨髓浸润同时存在较为多见，包括脑膜、脑神经、脑实质、脊髓、脊髓旁及混合性浸润，出现头痛、呕吐等颅高压症状，或面瘫、感觉障碍、肌力改变、截瘫等。 | [
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"id": 0,
"entity": "儿童NHL",
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"end_offset": 5,
"label": "dis"
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{
"id": 1,
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"end_offset": 22,
"label": "bod"
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{
"id": 2,
"entity": "NHL",
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{
"id": 3,
"entity": "骨髓",
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"label": "bod"
},
{
"id": 4,
"entity": "脑膜",
"start_offset": 61,
"end_offset": 63,
"label": "bod"
},
{
"id": 5,
"entity": "脑神经",
"start_offset": 64,
"end_offset": 67,
"label": "bod"
},
{
"id": 6,
"entity": "脑实质",
"start_offset": 68,
"end_offset": 71,
"label": "bod"
},
{
"id": 7,
"entity": "脊髓",
"start_offset": 72,
"end_offset": 74,
"label": "bod"
},
{
"id": 8,
"entity": "脊髓",
"start_offset": 75,
"end_offset": 77,
"label": "bod"
},
{
"id": 9,
"entity": "出现头痛、呕吐等颅高压症状",
"start_offset": 85,
"end_offset": 98,
"label": "sym"
},
{
"id": 10,
"entity": "面瘫",
"start_offset": 100,
"end_offset": 102,
"label": "sym"
},
{
"id": 11,
"entity": "感觉障碍",
"start_offset": 103,
"end_offset": 107,
"label": "sym"
},
{
"id": 12,
"entity": "肌力改变",
"start_offset": 108,
"end_offset": 112,
"label": "sym"
},
{
"id": 13,
"entity": "截瘫",
"start_offset": 113,
"end_offset": 115,
"label": "sym"
}
] |
如不给予中枢浸润预防性措施，病程中中枢浸润机会很高，眼神经与面神经受累机会较多。 | [
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"id": 0,
"entity": "中枢",
"start_offset": 4,
"end_offset": 6,
"label": "bod"
},
{
"id": 1,
"entity": "中枢",
"start_offset": 17,
"end_offset": 19,
"label": "bod"
},
{
"id": 2,
"entity": "眼神经",
"start_offset": 26,
"end_offset": 29,
"label": "bod"
},
{
"id": 3,
"entity": "面神经",
"start_offset": 30,
"end_offset": 33,
"label": "bod"
}
] |
少数病人因中枢浸润所致的临床表现而首诊。 | [
{
"id": 0,
"entity": "中枢",
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"end_offset": 7,
"label": "bod"
}
] |
【辅助检查】1.全身的影像学检查以评估疾病浸润范围，见分期检查。 | [
{
"id": 0,
"entity": "影像学检查",
"start_offset": 11,
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"label": "pro"
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] |
2.实验室检查①血清乳酸脱氢酶（LDH）水平与肿瘤成正相关，并和预后相关，因此在治疗前应进行评估；②高肿瘤负荷者可发生心、肝、肾等重要脏器的浸润而致功能不全，治疗前因仔细评估；③高负荷NHL在治疗前、初始治疗的一周内易发生肿瘤细胞溶解综合征，因此在这段时间内应定时进行肾功能、血电解质的监测；④进行增强CT检查前应先核实肾功能情况，有肿瘤细胞溶解综合征或肾功能不良时应避免增强CT，因造影剂可能加重肾功能不全；⑤外周血常规检查如存在贫血、血小板减少常提示为晚期或有骨髓浸润；⑥骨髓涂片可除外骨髓浸润；⑦浆膜腔液体沉渣涂片检查结合免疫表型检查有助于诊断、鉴别诊断和肿瘤浸润状态的评估。 | [
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"id": 0,
"entity": "血清乳酸脱氢酶",
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{
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"entity": "LDH",
"start_offset": 16,
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"label": "ite"
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{
"id": 2,
"entity": "肿瘤",
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"end_offset": 25,
"label": "dis"
},
{
"id": 3,
"entity": "肿瘤",
"start_offset": 51,
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"label": "dis"
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{
"id": 4,
"entity": "心",
"start_offset": 59,
"end_offset": 60,
"label": "bod"
},
{
"id": 5,
"entity": "肝",
"start_offset": 61,
"end_offset": 62,
"label": "bod"
},
{
"id": 6,
"entity": "肾",
"start_offset": 63,
"end_offset": 64,
"label": "bod"
},
{
"id": 7,
"entity": "NHL",
"start_offset": 92,
"end_offset": 95,
"label": "dis"
},
{
"id": 8,
"entity": "肿瘤细胞溶解综合征",
"start_offset": 111,
"end_offset": 120,
"label": "dis"
},
{
"id": 9,
"entity": "肾功能",
"start_offset": 134,
"end_offset": 137,
"label": "ite"
},
{
"id": 10,
"entity": "血电解质",
"start_offset": 138,
"end_offset": 142,
"label": "ite"
},
{
"id": 11,
"entity": "增强CT检查",
"start_offset": 149,
"end_offset": 155,
"label": "pro"
},
{
"id": 12,
"entity": "肾功能",
"start_offset": 160,
"end_offset": 163,
"label": "ite"
},
{
"id": 13,
"entity": "肿瘤细胞溶解综合征",
"start_offset": 167,
"end_offset": 176,
"label": "dis"
},
{
"id": 14,
"entity": "肾功能",
"start_offset": 177,
"end_offset": 180,
"label": "ite"
},
{
"id": 15,
"entity": "增强CT",
"start_offset": 186,
"end_offset": 190,
"label": "pro"
},
{
"id": 16,
"entity": "肾",
"start_offset": 199,
"end_offset": 200,
"label": "bod"
},
{
"id": 17,
"entity": "外周血常规",
"start_offset": 206,
"end_offset": 211,
"label": "pro"
},
{
"id": 18,
"entity": "贫血",
"start_offset": 216,
"end_offset": 218,
"label": "sym"
},
{
"id": 19,
"entity": "血小板减少",
"start_offset": 219,
"end_offset": 224,
"label": "sym"
},
{
"id": 20,
"entity": "骨髓",
"start_offset": 232,
"end_offset": 234,
"label": "bod"
},
{
"id": 21,
"entity": "骨髓涂片",
"start_offset": 238,
"end_offset": 242,
"label": "pro"
},
{
"id": 22,
"entity": "骨髓",
"start_offset": 245,
"end_offset": 247,
"label": "bod"
},
{
"id": 23,
"entity": "浆膜腔液体沉渣涂片检查",
"start_offset": 251,
"end_offset": 262,
"label": "pro"
},
{
"id": 24,
"entity": "免疫表型检",
"start_offset": 264,
"end_offset": 269,
"label": "pro"
},
{
"id": 25,
"entity": "肿瘤",
"start_offset": 281,
"end_offset": 283,
"label": "pro"
}
] |
【诊断标准】NHL的诊断必须依据于病理（细胞）形态学、免疫学和细胞/分子遗传学。 | [
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"id": 0,
"entity": "NHL",
"start_offset": 6,
"end_offset": 9,
"label": "dis"
}
] |
【疾病分期检查及分期标准】在治疗前必须先明确分期，常规分期检查包括以下项目：全身体格检查，眼底检查，骨髓活检及涂片，胸腹盆腔影像学检查（以增强CT检查为主），脑脊液离心甩片找肿瘤细胞，疑有中枢浸润时增强头颅MRI或CT以除外颅内转移，疑有骨骼浸润时全身骨扫描。 | [
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"id": 0,
"entity": "全身体格检查",
"start_offset": 38,
"end_offset": 44,
"label": "pro"
},
{
"id": 1,
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"start_offset": 45,
"end_offset": 49,
"label": "pro"
},
{
"id": 2,
"entity": "骨髓活检及涂片",
"start_offset": 50,
"end_offset": 57,
"label": "pro"
},
{
"id": 3,
"entity": "胸腹盆腔影像学检查",
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"end_offset": 67,
"label": "pro"
},
{
"id": 4,
"entity": "增强CT检查",
"start_offset": 69,
"end_offset": 75,
"label": "pro"
},
{
"id": 5,
"entity": "脑脊液离心甩片",
"start_offset": 79,
"end_offset": 86,
"label": "pro"
},
{
"id": 6,
"entity": "肿瘤细胞",
"start_offset": 87,
"end_offset": 91,
"label": "bod"
},
{
"id": 7,
"entity": "中枢",
"start_offset": 94,
"end_offset": 96,
"label": "bod"
},
{
"id": 8,
"entity": "增强头颅MRI或CT",
"start_offset": 99,
"end_offset": 109,
"label": "pro"
},
{
"id": 9,
"entity": "骨骼",
"start_offset": 119,
"end_offset": 121,
"label": "bod"
},
{
"id": 10,
"entity": "全身骨扫描",
"start_offset": 124,
"end_offset": 129,
"label": "pro"
}
] |
通过以上检查确定肿瘤浸润范围并据此作出临床分期。 | [
{
"id": 0,
"entity": "肿瘤",
"start_offset": 8,
"end_offset": 10,
"label": "dis"
}
] |
表11-16St.Jude非霍奇金淋巴瘤分期系统注：中枢神经系统浸润定义：1.CSFWBC≥5个/μl，并CSF标本离心发现淋巴瘤细胞；或2.有明确中枢神经系统受累症状或/和体怔，如脑神经瘫痪，并不能用其他原因解释；或3.脊髓浸润；或4.孤立性脑内肿瘤性病变。 | [
{
"id": 0,
"entity": "非霍奇金淋巴瘤",
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"end_offset": 20,
"label": "dis"
},
{
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"entity": "中枢神经系统",
"start_offset": 26,
"end_offset": 32,
"label": "bod"
},
{
"id": 2,
"entity": "CSFWBC",
"start_offset": 39,
"end_offset": 45,
"label": "ite"
},
{
"id": 3,
"entity": "CSF",
"start_offset": 53,
"end_offset": 56,
"label": "ite"
},
{
"id": 4,
"entity": "淋巴瘤细胞",
"start_offset": 62,
"end_offset": 67,
"label": "bod"
},
{
"id": 5,
"entity": "中枢神经系统",
"start_offset": 74,
"end_offset": 80,
"label": "bod"
},
{
"id": 6,
"entity": "脑神经瘫痪",
"start_offset": 91,
"end_offset": 96,
"label": "dis"
},
{
"id": 7,
"entity": "脊髓",
"start_offset": 111,
"end_offset": 113,
"label": "bod"
},
{
"id": 8,
"entity": "孤立性脑内肿瘤性病变",
"start_offset": 119,
"end_offset": 129,
"label": "dis"
}
] |
骨髓受累定义：1.骨髓穿刺涂片见≥5%但＜25%的幼稚淋巴细胞；2.或骨髓活检发现局灶性浸润【治疗】（一）整体治疗原则及目标治疗的目标是使疾病获得完全缓解并长期无病生存，同时获得正常的远期生命质量。 | [
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"id": 0,
"entity": "骨髓",
"start_offset": 0,
"end_offset": 2,
"label": "bod"
},
{
"id": 1,
"entity": "骨髓穿刺涂片",
"start_offset": 9,
"end_offset": 15,
"label": "pro"
},
{
"id": 2,
"entity": "幼稚淋巴细胞",
"start_offset": 25,
"end_offset": 31,
"label": "ite"
},
{
"id": 3,
"entity": "骨髓活检",
"start_offset": 35,
"end_offset": 39,
"label": "pro"
},
{
"id": 4,
"entity": "局灶性浸润",
"start_offset": 41,
"end_offset": 46,
"label": "sym"
}
] |
治疗原则上以化疗为主，根据不同分期、形态分型或/及免疫分型采用不同药物联合和强度的治疗方案。 | [
{
"id": 0,
"entity": "化疗",
"start_offset": 6,
"end_offset": 8,
"label": "pro"
}
] |
除中枢浸润、脊髓肿瘤压迫症、化疗后局部残留病灶、姑息性治疗等特殊情况外，常规治疗不推荐放疗。 | [
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"id": 0,
"entity": "中枢",
"start_offset": 1,
"end_offset": 3,
"label": "bod"
},
{
"id": 1,
"entity": "脊髓肿瘤压迫症",
"start_offset": 6,
"end_offset": 13,
"label": "dis"
},
{
"id": 2,
"entity": "化疗",
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"end_offset": 16,
"label": "pro"
},
{
"id": 3,
"entity": "姑息性治疗",
"start_offset": 24,
"end_offset": 29,
"label": "pro"
},
{
"id": 4,
"entity": "放疗",
"start_offset": 43,
"end_offset": 45,
"label": "pro"
}
] |
手术主要用于下列情况：①手术活检，尽量争取获得组织标本以明确诊断及分型，如肿块较小并为局限性病变，可将肿块完全切除。 | [
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"id": 0,
"entity": "手术",
"start_offset": 0,
"end_offset": 2,
"label": "pro"
},
{
"id": 1,
"entity": "手术活检",
"start_offset": 12,
"end_offset": 16,
"label": "pro"
},
{
"id": 2,
"entity": "肿块",
"start_offset": 51,
"end_offset": 53,
"label": "bod"
},
{
"id": 3,
"entity": "切除",
"start_offset": 55,
"end_offset": 57,
"label": "pro"
}
] |
估计肿块不能完全切除时应仅做小切口活检术，不推荐肿瘤部分或大部分切除术；②急腹症：出现如肠套叠、完全性肠梗阻、肠穿孔、严重的胃肠道出血等外科急腹症时考虑急诊手术；③二次活检及手术：化疗3个疗程后有稳定残留病灶时，应考虑再次活检（手术），为进一步治疗提供依据。 | [
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"id": 0,
"entity": "肿块",
"start_offset": 2,
"end_offset": 4,
"label": "bod"
},
{
"id": 1,
"entity": "活检术",
"start_offset": 17,
"end_offset": 20,
"label": "pro"
},
{
"id": 2,
"entity": "肿瘤部分或大部分切除术",
"start_offset": 24,
"end_offset": 35,
"label": "pro"
},
{
"id": 3,
"entity": "急腹症",
"start_offset": 37,
"end_offset": 40,
"label": "dis"
},
{
"id": 4,
"entity": "肠套叠",
"start_offset": 44,
"end_offset": 47,
"label": "dis"
},
{
"id": 5,
"entity": "完全性肠梗阻",
"start_offset": 48,
"end_offset": 54,
"label": "dis"
},
{
"id": 6,
"entity": "肠穿孔",
"start_offset": 55,
"end_offset": 58,
"label": "dis"
},
{
"id": 7,
"entity": "胃肠道出血",
"start_offset": 62,
"end_offset": 67,
"label": "dis"
},
{
"id": 8,
"entity": "外科",
"start_offset": 68,
"end_offset": 70,
"label": "dep"
},
{
"id": 9,
"entity": "急腹症",
"start_offset": 70,
"end_offset": 73,
"label": "dis"
},
{
"id": 10,
"entity": "急诊手术",
"start_offset": 76,
"end_offset": 80,
"label": "pro"
},
{
"id": 11,
"entity": "二次活检及手术",
"start_offset": 82,
"end_offset": 89,
"label": "pro"
},
{
"id": 12,
"entity": "化疗",
"start_offset": 90,
"end_offset": 92,
"label": "pro"
},
{
"id": 13,
"entity": "活检",
"start_offset": 111,
"end_offset": 113,
"label": "pro"
},
{
"id": 14,
"entity": "手术",
"start_offset": 114,
"end_offset": 116,
"label": "pro"
}
] |
（二）急诊处理儿童NHL临床进展较快，应将之视作急诊，尽快完成各项检查明确诊断。 | [
{
"id": 0,
"entity": "急诊",
"start_offset": 3,
"end_offset": 5,
"label": "pro"
},
{
"id": 1,
"entity": "儿童NHL",
"start_offset": 7,
"end_offset": 12,
"label": "dis"
},
{
"id": 2,
"entity": "急诊",
"start_offset": 24,
"end_offset": 26,
"label": "pro"
}
] |
如为巨大纵隔肿块伴有气道及上腔静脉压迫症状无外周淋巴结肿大骨髓及胸腹腔积液）也不能诊断时，可选择性采取肿块粗针穿刺活检、纵隔镜活检或胸骨旁切口活检。 | [
{
"id": 0,
"entity": "纵隔",
"start_offset": 4,
"end_offset": 6,
"label": "bod"
},
{
"id": 1,
"entity": "气道",
"start_offset": 10,
"end_offset": 12,
"label": "bod"
},
{
"id": 2,
"entity": "上腔静脉",
"start_offset": 13,
"end_offset": 17,
"label": "bod"
},
{
"id": 3,
"entity": "巨大纵隔肿块伴有气道及上腔静脉压迫症状",
"start_offset": 2,
"end_offset": 21,
"label": "sym"
},
{
"id": 4,
"entity": "外周淋巴结",
"start_offset": 22,
"end_offset": 27,
"label": "bod"
},
{
"id": 5,
"entity": "无外周淋巴结肿大",
"start_offset": 21,
"end_offset": 29,
"label": "sym"
},
{
"id": 6,
"entity": "骨髓",
"start_offset": 29,
"end_offset": 31,
"label": "bod"
},
{
"id": 7,
"entity": "胸腹腔积液",
"start_offset": 32,
"end_offset": 37,
"label": "bod"
},
{
"id": 8,
"entity": "粗针穿刺活检",
"start_offset": 53,
"end_offset": 59,
"label": "pro"
},
{
"id": 9,
"entity": "纵隔镜活检",
"start_offset": 60,
"end_offset": 65,
"label": "pro"
},
{
"id": 10,
"entity": "胸骨旁切口活检",
"start_offset": 66,
"end_offset": 73,
"label": "pro"
}
] |
如此时有危及生命的现象，全身麻醉过于危险，临床及影像学检查符合NHL，为抢救生命可给予紧急低剂量化疗，12～24小时后多数病人的压迫症状就可能得到缓解，病情稍稳定后再行活检（24～48小时内），但此时由于受化疗影响组织细胞学判断可能出现困难，因此应尽量避免先治疗后活检。 | [
{
"id": 0,
"entity": "临床及影像学检查",
"start_offset": 21,
"end_offset": 29,
"label": "pro"
},
{
"id": 1,
"entity": "NHL",
"start_offset": 31,
"end_offset": 34,
"label": "dis"
},
{
"id": 2,
"entity": "化疗",
"start_offset": 48,
"end_offset": 50,
"label": "pro"
},
{
"id": 3,
"entity": "活检",
"start_offset": 84,
"end_offset": 86,
"label": "pro"
},
{
"id": 4,
"entity": "化疗",
"start_offset": 103,
"end_offset": 105,
"label": "pro"
},
{
"id": 5,
"entity": "组织细胞",
"start_offset": 107,
"end_offset": 111,
"label": "bod"
},
{
"id": 6,
"entity": "活检",
"start_offset": 132,
"end_offset": 134,
"label": "pro"
}
] |
治疗时间越长病理诊断越困难，因此即使先治疗缓解危及生命的状况，也应积极准备在治疗48小时内进行活检手术。 | [
{
"id": 0,
"entity": "活检手术",
"start_offset": 47,
"end_offset": 51,
"label": "pro"
}
] |
对已明确诊断的肿瘤负荷较大的患儿，应尽早采用3～7天低强度化疗（如糖皮质激素和长春新碱），同时给予水化2000～3000ml/m2</sup>、5%碳酸氢钠5ml/kg碱化尿液、别嘌呤醇10mg/kg抑制过多的尿酸形成，维持水电解质酸碱平衡，避免肿瘤细胞溶解过快造成的肿瘤细胞溶解综合征。 | [
{
"id": 0,
"entity": "化疗",
"start_offset": 29,
"end_offset": 31,
"label": "pro"
},
{
"id": 1,
"entity": "糖皮质激素",
"start_offset": 33,
"end_offset": 38,
"label": "dru"
},
{
"id": 2,
"entity": "长春新碱",
"start_offset": 39,
"end_offset": 43,
"label": "dru"
},
{
"id": 3,
"entity": "水化",
"start_offset": 49,
"end_offset": 51,
"label": "pro"
},
{
"id": 4,
"entity": "碳酸氢钠",
"start_offset": 74,
"end_offset": 78,
"label": "dru"
},
{
"id": 5,
"entity": "碱化",
"start_offset": 84,
"end_offset": 86,
"label": "pro"
},
{
"id": 6,
"entity": "尿液",
"start_offset": 86,
"end_offset": 88,
"label": "bod"
},
{
"id": 7,
"entity": "别嘌呤醇",
"start_offset": 89,
"end_offset": 93,
"label": "dru"
},
{
"id": 8,
"entity": "尿酸",
"start_offset": 105,
"end_offset": 107,
"label": "bod"
},
{
"id": 9,
"entity": "水电解质",
"start_offset": 112,
"end_offset": 116,
"label": "bod"
},
{
"id": 10,
"entity": "酸",
"start_offset": 116,
"end_offset": 117,
"label": "bod"
},
{
"id": 11,
"entity": "碱",
"start_offset": 117,
"end_offset": 118,
"label": "bod"
},
{
"id": 12,
"entity": "肿瘤细胞",
"start_offset": 123,
"end_offset": 127,
"label": "bod"
},
{
"id": 13,
"entity": "肿瘤细胞溶解综合征",
"start_offset": 134,
"end_offset": 143,
"label": "dis"
}
] |
（三）支持治疗（1）治疗期及治疗结束后1月TMP-SMZ50mg/（kg•d）分两次口服，每周用三天，大剂量MTX前24小时至MTX血浓度降至＜0.1μmol/L期间停用。 | [
{
"id": 0,
"entity": "TMP-SMZ",
"start_offset": 21,
"end_offset": 28,
"label": "dru"
},
{
"id": 1,
"entity": "MTX",
"start_offset": 54,
"end_offset": 57,
"label": "dru"
},
{
"id": 2,
"entity": "MTX血浓度",
"start_offset": 63,
"end_offset": 69,
"label": "ite"
}
] |
以预防肺孢子虫感染。 | [
{
"id": 0,
"entity": "肺孢子虫",
"start_offset": 3,
"end_offset": 7,
"label": "mic"
}
] |
（2）当外周血白细胞＜1000/cm3</sup>或粒细胞绝对计数＜500/cm3时应用C-CSF或GM-CSF5μg/（kg•d）至外周血白细胞＞2000/cm3</sup>。 | [
{
"id": 0,
"entity": "外周血白细胞",
"start_offset": 4,
"end_offset": 10,
"label": "ite"
},
{
"id": 1,
"entity": "粒细胞",
"start_offset": 26,
"end_offset": 29,
"label": "ite"
},
{
"id": 2,
"entity": "C-CSF",
"start_offset": 44,
"end_offset": 49,
"label": "dru"
},
{
"id": 3,
"entity": "GM-CSF5",
"start_offset": 50,
"end_offset": 57,
"label": "dru"
},
{
"id": 4,
"entity": "外周血白细胞",
"start_offset": 67,
"end_offset": 73,
"label": "ite"
}
] |
（3）血小板减少并有活动性出血或血小板＜20×109</sup>/L输注血小板。 | [
{
"id": 0,
"entity": "血小板",
"start_offset": 3,
"end_offset": 6,
"label": "bod"
},
{
"id": 1,
"entity": "血小板",
"start_offset": 16,
"end_offset": 19,
"label": "bod"
},
{
"id": 2,
"entity": "血小板",
"start_offset": 36,
"end_offset": 39,
"label": "bod"
}
] |
（四）各亚型NHL的方案选择根据病理形态学分型及/或免疫分型，分别采用成熟B细胞型NHL（非淋巴母细胞型）或淋巴母细胞型NHL（免疫表型为前驱T或前驱B）治疗方案，根据分期及分组化疗强度不同。 | [
{
"id": 0,
"entity": "亚型NHL",
"start_offset": 4,
"end_offset": 9,
"label": "dis"
},
{
"id": 1,
"entity": "成熟B细胞型NHL",
"start_offset": 35,
"end_offset": 44,
"label": "dis"
},
{
"id": 2,
"entity": "淋巴母细胞型NHL",
"start_offset": 54,
"end_offset": 63,
"label": "dis"
},
{
"id": 3,
"entity": "化疗",
"start_offset": 89,
"end_offset": 91,
"label": "pro"
}
] |
成熟B细胞性NHL（代表性疾病为伯基特淋巴瘤）的化疗方案原则是短程、强烈，以烷化剂和抗代谢性药物（主要是甲氨蝶呤和阿糖胞苷）为主，化疗强度根据临床分组或分期而定。 | [
{
"id": 0,
"entity": "B细胞性NHL",
"start_offset": 2,
"end_offset": 9,
"label": "dis"
},
{
"id": 1,
"entity": "伯基特淋巴瘤",
"start_offset": 16,
"end_offset": 22,
"label": "dis"
},
{
"id": 2,
"entity": "化疗",
"start_offset": 24,
"end_offset": 26,
"label": "pro"
},
{
"id": 3,
"entity": "甲氨蝶呤",
"start_offset": 52,
"end_offset": 56,
"label": "dru"
},
{
"id": 4,
"entity": "阿糖胞苷",
"start_offset": 57,
"end_offset": 61,
"label": "dru"
},
{
"id": 5,
"entity": "化疗",
"start_offset": 65,
"end_offset": 67,
"label": "dru"
}
] |
而对前驱T或B淋巴细胞型NHL（形态为淋巴母细胞型）的化疗方案原则与急性淋巴细胞白血病（ALL）一致。 | [
{
"id": 0,
"entity": "前驱T或B淋巴细胞型NHL",
"start_offset": 2,
"end_offset": 15,
"label": "dis"
},
{
"id": 1,
"entity": "化疗",
"start_offset": 27,
"end_offset": 29,
"label": "pro"
},
{
"id": 2,
"entity": "急性淋巴细胞白血病",
"start_offset": 34,
"end_offset": 43,
"label": "dis"
},
{
"id": 3,
"entity": "ALL",
"start_offset": 44,
"end_offset": 47,
"label": "dis"
}
] |
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