West China Hospital, Sichuan University, Chengdu, People's Republic of China.
J Clin Gastroenterol. 2013 Sep;47(8):e74-9. doi: 10.1097/MCG.0b013e31829e444f.
The gastrointestinal tract is the most common primary site of extranodal lymphomas, whereas gastrointestinal natural killer/T-cell (GINKT) lymphomas are relatively rare. To date, neither the prognostic characteristics nor the clinical features or optimal therapeutic approach for GINKT has yet been defined.
In this study, a retrospective analysis was carried out on clinical data obtained from 47 patients diagnosed with GINKT lymphoma between May 1999 and August 2011 at West China Hospital.
Patients had a median age of 37 years. Thirty-five of the patients were men (74.5%). The common clinical manifestations included fever (78.7%) and abdominal pain (76.6%). Seventeen patients had intestinal perforation (36.2%). All patients showed ulcerative lesions; the most common site of involvement was the colon (27/47; 57.4%), followed by the jejunoileum and ileocecum (14/47; 29.8%). The median survival period was 2.83 (95% confidence interval, 0.27-29) months. Age, perforation, B syndrome, staging according to Lugano system, and surgery were independent prognostic risk factors for GINKT lymphoma.
This study concluded that GINKT lymphoma is prone to perforation, hemorrhage, and other complications; moreover, the prognosis is very poor. The Lugano staging is a relatively suitable staging system. Surgery before perforation is a key therapy factor that affected prognosis. Although the roles played by chemotherapy and radiotherapy are unclear, combination therapy is necessary.
胃肠道是结外淋巴瘤最常见的原发部位,而胃肠道自然杀伤/T 细胞(GINKT)淋巴瘤则相对少见。迄今为止,GINKT 的预后特征、临床特征或最佳治疗方法尚未确定。
本研究对 1999 年 5 月至 2011 年 8 月在华西医院诊断为 GINKT 淋巴瘤的 47 例患者的临床资料进行了回顾性分析。
患者的中位年龄为 37 岁,35 例为男性(74.5%)。常见的临床表现包括发热(78.7%)和腹痛(76.6%)。17 例患者发生肠穿孔(36.2%)。所有患者均有溃疡性病变;最常见的受累部位是结肠(27/47;57.4%),其次是空肠回肠和回盲部(14/47;29.8%)。中位生存时间为 2.83 个月(95%置信区间:0.27-29)。年龄、穿孔、B 症状、卢加诺分期和手术是 GINKT 淋巴瘤的独立预后危险因素。
本研究表明,GINKT 淋巴瘤易发生穿孔、出血等并发症,预后极差。卢加诺分期是一种相对合适的分期系统。穿孔前手术是影响预后的关键治疗因素。虽然化疗和放疗的作用尚不清楚,但联合治疗是必要的。