原发性胃肠道非霍奇金淋巴瘤的临床特征及疗效分析

背景与目的:原发性胃肠道淋巴瘤是来源于结外淋巴组织的非霍奇金淋巴瘤(non-Hodgkinslymphoma,NHL),具有独特的临床病理特征。本文报告原发性胃肠道淋巴瘤的临床病理特征及其治疗效果。方法:回顾性分析我院1994年1月至2000年6月收治的经病理检查证实的22例原发性胃肠道淋巴瘤患者的病例资料。结果:本研究所有病例均随访3年以上,随访5年以上13例,3、5年生存率分别为45.5%(10/22)、38.5%(5/13);随着临床分期增高,3、5年生存率降低;低度恶性边缘带粘膜相关淋巴组织淋巴瘤较其它病理类型预后为佳;16例治疗后达到完全缓解者,3、5年生存率分别为62.5%(10/16)、45.5%(5/11),而6例原发灶未控者3年生存率为0,有显著性差异(P<0.05);12例单纯手术治疗者3、5年生存率分别为33.3%(4/12)、10%(1/10),6例手术联合化、放疗者(5例手术后辅助化疗,1例手术后行全腹照射)的3、5年生存率分别为83.3%(5/6)、66.7%(2/3)。结论:原发性胃肠道淋巴瘤应以综合治疗为主,原发灶未控可影响预后。

Clinical study of 22 cases of primary gastrointestinal lymphoma

BACKGROUND & OBJECTIVE: Primary gastrointestinal lymphoma (PGIL) is extranodal non-Hodgkin's lymphoma (NHL) that originates from extra-nodal tissue of gastrointestinal (GI) tract and has specific clinical and pathological features. This study was to report the clinical and pathological features as well as the treatment outcome of this disease. METHODS: The clinical data of 22 cases of PGIL admitted and treated from January 1994 to June 2000 in the First Hospital of Xi'an Jiaotong University were analyzed retrospectively. The diagnosis was confirmed histologically. RESULTS: All the patients were followed up for more than 3 years; among them 13 patients were followed up to 5 years. The 3-year and 5-year survival rates were 45.5% (10/22) and 38.5% (5/13), respectively. The survival rates decreased with the progression of the clinical stage. Low-grade marginal zone derived mucosa-associated lymphoid tissue lymphoma (MALT) showed a better prognosis than other pathological types. Of the 16 patients who received treatment attained complete remission (CR), the 3-year and 5-year survival rates were 62.5% (10/16) and 45.5% (5/11), respectively, whereas the 3-year and 5-year survival rates of the 6 non-controlled patients were 0 and 0. Among the twelve cases treated with surgery alone, the 3-year and 5-year survival rates were 33.3% (4/12) and 10% (1/10), respectively. For those receiving surgery combined with chemotherapy and radiotherapy (5 cases received adjuvant chemotherapy after surgery, and 1 patient received abdominal irradiation after the surgery), the 3-year and 5-year survival rates were 83.3% (5/6) and 66.7% (2/3), respectively. CONCLUSION: The prognosis of PGIL is related to control of the primary disease.