Nakamura Shotaro, Matsumoto Takayuki, Iida Mitsuo, Yao Takashi, Tsuneyoshi Masazumi
Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Cancer. 2003 May 15;97(10):2462-73. doi: 10.1002/cncr.11415.
An optimal treatment modality for patients with primary gastrointestinal lymphoma has not yet been established. This study aimed to elucidate the clinicopathologic features of this disease and the influence of therapeutic modalities on the prognosis in Japanese patients
The clinicopathologic features of 455 patients with primary gastrointestinal lymphoma were investigated retrospectively regarding treatment modalities and time trends.
This study comprised 342 patients (75%) with gastric lymphoma, 96 patients (22%) with intestinal lymphoma, and 17 patients (4%) with both gastric and intestinal lymphoma. Two hundred thirty-one (51%) patients were classified as having low-grade B-cell lymphoma including 200 marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT) type, 185 (41%) patients were classified as having high-grade B-cell lymphoma including 76 diffuse large cell lymphoma plus MALT lymphoma, and 39 (9%) patients were classified as having T-cell lymphoma. The frequency of nonsurgical treatment, including Helicobacter pylori eradication, chemotherapy, and radiation, increased during the latest decade. Patients who received nonsurgical treatment showed a better overall survival than those treated by surgery, but event-free survival did not differ between two groups. Cox multivariate analysis revealed that early stage, younger age, gastric localization, B-cell phenotype, and absence of B symptoms were independent prognostic factors for better overall and event-free survivals. Mucosa-associated lymphoid tissue-derived lymphoma was also an independent prognostic factor for event-free survival, but not for overall survival.
Nonsurgical treatment may be an optimal therapeutic modality for patients with primary gastrointestinal lymphoma.
原发性胃肠道淋巴瘤患者的最佳治疗方式尚未确立。本研究旨在阐明该疾病的临床病理特征以及治疗方式对日本患者预后的影响。
回顾性研究455例原发性胃肠道淋巴瘤患者的临床病理特征，涉及治疗方式和时间趋势。
本研究包括342例（75%）胃淋巴瘤患者、96例（22%）肠淋巴瘤患者和17例（4%）胃和肠均有淋巴瘤的患者。231例（51%）患者被归类为低度B细胞淋巴瘤，其中包括200例黏膜相关淋巴组织（MALT）型边缘区淋巴瘤；185例（41%）患者被归类为高度B细胞淋巴瘤，其中包括76例弥漫大细胞淋巴瘤加MALT淋巴瘤；39例（9%）患者被归类为T细胞淋巴瘤。在最近十年中，包括幽门螺杆菌根除、化疗和放疗在内的非手术治疗频率有所增加。接受非手术治疗的患者总体生存率高于接受手术治疗的患者，但两组的无事件生存率无差异。Cox多因素分析显示，早期、年轻、胃部定位、B细胞表型以及无B症状是总体生存和无事件生存较好的独立预后因素。黏膜相关淋巴组织来源的淋巴瘤也是无事件生存的独立预后因素，但不是总体生存的独立预后因素。
非手术治疗可能是原发性胃肠道淋巴瘤患者的最佳治疗方式。
