CAJ | 학술논문

目的探讨肠道原发性非霍奇金淋巴瘤(PINHL)的临床病理学特征及预后因素.方法收集确诊的273例PINHL患者资料,分析临床病理学特点、诊断情况及预后影响因素.结果 273例患者中男女比例为2.3∶1,中位发病年龄为46(2～85)岁,B细胞淋巴瘤组以腹部包块多见,而T细胞淋巴瘤组以穿孔、下腹疼痛及B症状更为常见.病变部位以回盲部最多见(30.4％).肠镜活检确诊率为90.3％.病理学分型:B细胞淋巴瘤232例(85.0％),以弥漫大B细胞淋巴瘤,非特指型(DLBCL,NOS)最为多见(48.4％);T细胞淋巴瘤41例(15.0％),以肠病相关性T细胞淋巴瘤最为多见(36.6％).获得完整随访资料者245例,B细胞淋巴瘤组患者预后明显好于T细胞淋巴瘤组(P＜0.05),手术对于患者整体生存率无明显影响,但对于侵袭性淋巴瘤患者可以提高其生存率.结论国人PINHL以B细胞淋巴瘤多发,T、B细胞淋巴瘤患者具有不同的临床特点.肠镜活检是较好的确诊方法.B细胞淋巴瘤患者预后明显好于T细胞淋巴瘤,侵袭性淋巴瘤患者可能从手术中获益.
목적 탐토장도원발성비곽기금림파류(PINHL)적림상병이학특정급예후인소.방법 수집학진적273례PINHL환자자료,분석림상병이학특점、진단정황급예후영향인소.결과 273례환자중남녀비례위2.3∶1,중위발병년령위46(2～85)세,B세포림파류조이복부포괴다견,이T세포림파류조이천공、하복동통급B증상경위상견.병변부위이회맹부최다견(30.4％).장경활검학진솔위90.3％.병이학분형:B세포림파류232례(85.0％),이미만대B세포림파류,비특지형(DLBCL,NOS)최위다견(48.4％);T세포림파류41례(15.0％),이장병상관성T세포림파류최위다견(36.6％).획득완정수방자료자245례,B세포림파류조환자예후명현호우T세포림파류조(P＜0.05),수술대우환자정체생존솔무명현영향,단대우침습성림파류환자가이제고기생존솔.결론 국인PINHL이B세포림파류다발,T、B세포림파류환자구유불동적림상특점.장경활검시교호적학진방법.B세포림파류환자예후명현호우T세포림파류,침습성림파류환자가능종수술중획익.
Objective To study the clinicopathological characteristics and prognostic factors in Chinese patients with primary intestinal non-Hodgkin' s lymphomas (PINHL).Methods The clinical symptoms,pathological features,diagnostic and prognostic factors of 273 cases diagnosed with PINHL from our center were analyzed.Results Among 273 cases,189 were male and 84 female,the male to female ratio was 2.3 ∶ 1.The age of patients ranged from 2 to 85 years old with the median age of 46.The most frequent site of the lesions was ileocecus (n=83,30.4％).The clinical symptoms of PINHL were unspecific with abdominal mass frequently seen in B-cell lymphoma,and perforation,hypogastric pain and "B" symptoms more common in T-cell lymphoma.Endoscopic biopsy diagnosis rate was 90.3％.Of 273 cases,B-cell lymphoma (n=232,85.0％) dominated PINHL with the most common subtype of diffuse large B-cell lymphoma-not otherwise specified (DLBCL-NOS) (n=132,48.4％),while the T-cell lymphoma (n=41,15.0％) were much less seen with the most common subtype of enteropathy-associated T-cell lymphoma (EATL) (n=15,36.6％).There were 245 cases were followed up,including 206 cases of B-cell lymphoma and 39 cases of T-cell lymphoma,it was found that the prognosis of B-cell lymphoma is much better than that of T-cell lymphoma (P＜0.05).Operation had no significant effect for the overall survival rate.But for patients with aggressive lymphoma,operation can improve the survival rate.Conclusions It indicates that PINHL often occurs as B cell type,DLBCL-NOS is the most common histological type.Ileocecus is the most common site involved and enteroscope biopsy is a good method of diagnosis.Compared with T-cell lymphoma,B-cell lymphoma has different clinical manifestations and a better prognosis.Patients with aggressive lymphoma can benefit from operation.