原发性胃弥漫性大B细胞淋巴瘤治疗后胃腺癌风险增加。
Increased risk of gastric adenocarcinoma after treatment of primary gastric diffuse large B-cell lymphoma.
作者信息
Inaba Koji, Kushima Ryoji, Murakami Naoya, Kuroda Yuuki, Harada Ken, Kitaguchi Mayuka, Yoshio Kotaro, Sekii Shuhei, Takahashi Kana, Morota Madoka, Mayahara Hiroshi, Ito Yoshinori, Sumi Minako, Uno Takashi, Itami Jun
机构信息
Department of Radiation Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan.
出版信息
BMC Cancer. 2013 Oct 26;13:499. doi: 10.1186/1471-2407-13-499.
BACKGROUND
There have been sporadic reports about synchronous as well as metachronous gastric adenocarcinoma and primary gastric lymphoma. Many reports have dealt with metachronous gastric adenocarcinoma in mucosa-associated lymphoid tissue lymphoma of stomach. But to our knowledge, there have been no reports that document the increased incidence of metachronous gastric adenocarcinoma in patients with gastric diffuse large B-cell lymphoma. This retrospective study was conducted to estimate the incidence of metachronous gastric adenocarcinoma after primary gastric lymphoma treatment, especially in diffuse large B-cell lymphoma.
METHODS
The retrospective cohort study of 139 primary gastric lymphoma patients treated with radiotherapy at our hospital. Mean observation period was 61.5 months (range: 3.7-124.6 months). Patients profile, characteristics of primary gastric lymphoma and metachronous gastric adenocarcinoma were retrieved from medical records. The risk of metachronous gastric adenocarcinoma was compared with the risk of gastric adenocarcinoma in Japanese population.
RESULTS
There were 10 (7.2%) metachronous gastric adenocarcinoma patients after treatment of primary gastric lymphomas. It was quite high risk compared with the risk of gastric carcinoma in Japanese population of 54.7/100,000. Seven patients of 10 were diffuse large B-cell lymphoma and other 3 patients were mixed type of diffuse large B-cell lymphoma and mucosa associated lymphoid tissue lymphoma. Four patients of 10 metachronous gastric adenocarcinomas were signet-ring cell carcinoma and two patients died of gastric adenocarcinoma. Metachronous gastric adenocarcinoma may have a more malignant potential than sporadic gastric adenocarcinoma. Old age, Helicobacter pylori infection and gastric mucosal change of chronic gastritis and intestinal metaplasia were possible risk factors for metachronous gastric adenocarcinoma.
CONCLUSION
There was an increased risk of gastric adenocarcinoma after treatment of primary gastric lymphoma, especially of diffuse large B-cell lymphoma.
背景
关于同时性和异时性胃腺癌与原发性胃淋巴瘤的报道较为零散。许多报道涉及胃黏膜相关淋巴组织淋巴瘤中的异时性胃腺癌。但据我们所知，尚无报道记录胃弥漫性大B细胞淋巴瘤患者异时性胃腺癌的发病率增加情况。本回顾性研究旨在评估原发性胃淋巴瘤治疗后，尤其是弥漫性大B细胞淋巴瘤患者异时性胃腺癌的发病率。
方法
对我院139例接受放疗的原发性胃淋巴瘤患者进行回顾性队列研究。平均观察期为61.5个月（范围：3.7 - 124.6个月）。从病历中获取患者资料、原发性胃淋巴瘤及异时性胃腺癌的特征。将异时性胃腺癌的风险与日本人群中胃腺癌的风险进行比较。
结果
原发性胃淋巴瘤治疗后有10例（7.2%）患者发生异时性胃腺癌。与日本人群中胃癌发病率54.7/10万相比，该风险相当高。10例患者中有7例为弥漫性大B细胞淋巴瘤，另外3例为弥漫性大B细胞淋巴瘤与黏膜相关淋巴组织淋巴瘤的混合型。10例异时性胃腺癌患者中有4例为印戒细胞癌，2例死于胃腺癌。异时性胃腺癌可能比散发性胃腺癌具有更高的恶性潜能。老年、幽门螺杆菌感染以及慢性胃炎和肠化生的胃黏膜改变可能是异时性胃腺癌的潜在危险因素。
结论
原发性胃淋巴瘤治疗后，尤其是弥漫性大B细胞淋巴瘤患者，发生胃腺癌的风险增加。
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