原发性结肠恶性淋巴瘤42例诊治分析

目的探讨原发性结肠恶性淋巴瘤的临床特点,以提高本病的诊断和治疗水平。方法回顾性分析我院1980年1月至2004年12月收治的42例原发性结肠恶性淋巴瘤的诊断、治疗和随访资料。结果42例患者均行手术探查,手术切除率为90·5%,其中根治性手术达78·6%。病理类型均属非霍奇金淋巴瘤,其中B细胞淋巴瘤30例,占71·4%,T细胞淋巴瘤12例,占28·6%。随访30例手术加化疗或放疗患者,其中24例术后生存超过5年(5年生存率80·0%),9例术后生存超过10年(10年生存率30·0%),6例死于淋巴瘤复发,消化道出血、穿孔及感染性休克等。结论本病的临床表现多样,术前误诊率较高;内镜下多次多点活检、深凿活检可提高本病的确诊率;以手术为主的综合治疗可提高本病的生存率。

Diagnosis and treatment of 42 patients with malignant lymphoma of colon

Objective To explore the clinical characteristics and the diagnosis and treatment of primary colonic malignant lymphoma (PCML). Methods Forty-two patients with PCML admitted from 1980 to 2004 were analysed retrospectively. Results All patients were treated surgically. The resection rate was 90.5% and the radical operation rate was 78.6%. The pathological examination showed non-Hodgkin lymphoma (NHL) in all patients including 30 cases of B cell lymphoma and 12 cases of T cell lymphoma. 30 patients who underwent operation, chemotherapy or radiotherapy were followed up, and 24 of survived for more than 5 years, with the 5-year survival rate of 80.0%. 9 cases survived ten years, and the 10-year survival rate was 30.0%. 6 cases died of recurrence of PCML, digestive tract bleeding, performation or infectious shock. Conclusions PCML is characterized by multiple clinical manifestations and the misdiagnosis rate is high. The combined therapies with the surgical treatment as the first selection may prolong survival of patients.