Wan Wei, Wang Jing, Jing Hong-mei, Wang Ji-jun, Liu Yan, Zhao Wei, Chen Yu-ping, Ke Xiao-yan
Department of Hematology, Peking University Third Hospital, Beijing, China.
Zhonghua Xue Ye Xue Za Zhi. 2011 Oct;32(10):652-5.
To explore the pathologic types, prognostic factors and effective treatment of PGI-NHL.
Clinical data of 110 PGI-NHL patients were analyzed retrospectively, and so did prognostic factors and each treatment outcome.
Of the 110 patients, the male-female ratio was 1.56:1 with a median age of 58.5 years. Stomach was the most common site and small intestine was the second. The main histological subtypes were diffuse large B-cell lymphoma (DLBCL) and mucosa-associated lymphoid tissue (MALT) NHL. Among the 75 patients followed up, the 5-year overall survival (OS) rate was 62%, the median survival time was 36 months. Univariate analysis showed a similar prognosis between PG-NHL and primary bowel NHL (P > 0.05), and PGI-MALT had better prognosis than PGI-DLBCL. Among PGI-DLBCL, the ratio of germinal center (GC) sub-type to non-GC was 1:2.82. Among three main treatments, chemotherapy combined with surgery had the lowest mortality rate, compared with each alone. Disease progress mortality was 51.7% of overall mortality.
The percent of non-GC in PGI-DLBCL is higher than that of in non PGI-NHL. The 5-year OS rate is lower than the 5-year OS rate of DLBCL. Combined chemotherapy is the first line treatment. Surgery is important in the control of the complications of GI tract. Maintenance treatment is important even in those who had systemic treatments.
探讨原发性胃肠道非霍奇金淋巴瘤(PGI-NHL)的病理类型、预后因素及有效治疗方法。
回顾性分析110例PGI-NHL患者的临床资料,以及预后因素和各治疗结果。
110例患者中,男女比例为1.56:1,中位年龄为58.5岁。胃是最常见的发病部位,小肠次之。主要组织学亚型为弥漫性大B细胞淋巴瘤(DLBCL)和黏膜相关淋巴组织(MALT)型非霍奇金淋巴瘤。在75例接受随访的患者中,5年总生存率(OS)为62%,中位生存时间为36个月。单因素分析显示,PG-NHL与原发性肠道非霍奇金淋巴瘤的预后相似(P>0.05),PGI-MALT的预后优于PGI-DLBCL。在PGI-DLBCL中,生发中心(GC)亚型与非GC亚型的比例为1:2.82。在三种主要治疗方法中,化疗联合手术的死亡率最低,与单独使用每种方法相比。疾病进展死亡率占总死亡率的51.7%。
PGI-DLBCL中非GC的比例高于非PGI-NHL。5年总生存率低于弥漫性大B细胞淋巴瘤的5年总生存率。联合化疗是一线治疗方法。手术对于控制胃肠道并发症很重要。即使是接受了全身治疗的患者,维持治疗也很重要。