Department of Laser Treatment and Endoscopy, Sun Yat-Sen University Cancer Center, Guangzhou 510060, Guangdong Province, China.
World J Gastroenterol. 2011 Nov 7;17(41):4625-31. doi: 10.3748/wjg.v17.i41.4625.
To analyze the clinicopathologic features and the prognosis of primary intestinal lymphoma.
Patients were included in the study based on standard diagnostic criteria for primary gastrointestinal lymphoma, and were treated at Sun Yat-sen University Cancer Centre between 1993 and 2008.
The study comprised 81 adults. The most common site was the ileocaecal region. Twenty-two point two percent patients had low-grade B-cell lymphoma. Fifty-one point nine percent patients had high-grade B-cell lymphoma and 25.9% patients had T-cell lymphoma. Most patients had localized disease. There were more patients and more early stage diseases in the latter period, and the origin sites changed. The majority of patients received the combined treatment, and about 20% patients only received nonsurgical therapy. The wverall survival and event-free survival rates after 5 years were 71.6% and 60.9% respectively. The multivariate analysis revealed that small intestine and ileocaecal region localization, B-cell phenotype, and normal lactate dehydrogenase were independent prognostic factors for better patient survival. Surgery based treatment did not improve the survival rate.
Refined stratification of the patients according to the prognostic variables may allow individualized treatment. Conservative treatment may be an optimal therapeutic modality for selected patients.
分析原发性肠道淋巴瘤的临床病理特征和预后。
本研究纳入了中山大学肿瘤防治中心于 1993 年至 2008 年期间按照原发性胃肠道淋巴瘤的标准诊断标准诊断并治疗的患者。
该研究共纳入 81 例成年人。最常见的发病部位是回盲部。22.2%的患者为低级别 B 细胞淋巴瘤,51.9%的患者为高级别 B 细胞淋巴瘤,25.9%的患者为 T 细胞淋巴瘤。大多数患者的疾病局限于局部。与早期相比,晚期患者更多,且发病部位发生了变化。大多数患者接受了联合治疗,约 20%的患者仅接受了非手术治疗。5 年后,患者的总生存率和无事件生存率分别为 71.6%和 60.9%。多因素分析显示,小肠和回盲部定位、B 细胞表型和正常乳酸脱氢酶是患者生存更好的独立预后因素。基于手术的治疗并未提高生存率。
根据预后变量对患者进行精细分层可能有助于实现个体化治疗。对于某些特定患者,保守治疗可能是一种最佳的治疗方式。