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中国 47 例胃肠道 NK/T 细胞淋巴瘤患者的预后特征分析。

Prognostic characteristics of gastrointestinal tract NK/T-cell lymphoma: an analysis of 47 patients in China.

机构信息

West China Hospital, Sichuan University, Chengdu, People's Republic of China.

出版信息

J Clin Gastroenterol. 2013 Sep;47(8):e74-9. doi: 10.1097/MCG.0b013e31829e444f.

Abstract

BACKGROUND

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.

PATIENTS AND METHODS

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.

RESULTS

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.

CONCLUSIONS

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.

摘要

背景

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。

患者与方法

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。

结果

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。

结论

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。

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