Fujishima Fumiyoshi, Katsushima Hiroki, Fukuhara Noriko, Konosu-Fukaya Sachiko, Nakamura Yasuhiro, Sasano Hironobu, Ichinohasama Ryo
Department of Anatomic Pathology, Tohoku University Graduate School of Medicine.
Division of Hematopathology, Tohoku University Hospital.
Tohoku J Exp Med. 2018 Jul;245(3):159-165. doi: 10.1620/tjem.245.159.
Primary gastrointestinal lymphoma (PGIL) has been reported in many studies of lymphomas of the gastrointestinal tract worldwide. However, there have been few accurate population-based reports on lymphomas, and it is difficult to apply the strict definition of PGIL to all lymphomas occurring in the gastrointestinal tract. Accordingly, instead of using PGIL, this study included newly diagnosed lymphomas with biopsy or excision specimens obtained from the gastrointestinal tract (GI-related lymphomas) and aimed at presenting the incidence rate, subtype frequency, and occurrence site of GI-related lymphomas. Additionally, we examined GI-related lymphomas diagnosed using flow cytometry (FCM) analysis, cytogenetics analysis, and molecular analysis (multimetric and/or integrated analysis). We extracted data on GI-related lymphomas from 2,098 lymphoma cases registered from the entire Miyagi Prefecture in Japan. The number of GI-related lymphomas was 350, and the incidence rate was 2.97 per 100,000 persons. Diffuse large B-cell lymphoma was the most common subtype (47.4%), followed by extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (32.6%) and follicular lymphoma (8.3%). The stomach was the most common site (62.6%), followed by the large intestine (15.4%), small intestine (14.3%), and duodenum (6.0%). Of the 350 included cases, 111 were diagnosed using multimetric and/or integrated analysis, in which the proportions of positive results for FCM analysis, cytogenetics analysis, and molecular analysis were 81%, 33%, and 51%, respectively. These results may provide a representation of lymphomas occurring in the gastrointestinal tract in Japan. Multimetric and/or integrated analysis of GI-related lymphomas could enable us to acquire useful information for the diagnosis.
原发性胃肠道淋巴瘤（PGIL）在全球许多关于胃肠道淋巴瘤的研究中均有报道。然而，基于人群的淋巴瘤准确报告较少，且难以将PGIL的严格定义应用于所有发生在胃肠道的淋巴瘤。因此，本研究未使用PGIL，而是纳入了通过活检或切除从胃肠道获得标本的新诊断淋巴瘤（胃肠道相关淋巴瘤），旨在呈现胃肠道相关淋巴瘤的发病率、亚型频率及发生部位。此外，我们还检查了通过流式细胞术（FCM）分析、细胞遗传学分析和分子分析（多指标和/或综合分析）诊断的胃肠道相关淋巴瘤。我们从日本宫城县登记的2098例淋巴瘤病例中提取了胃肠道相关淋巴瘤的数据。胃肠道相关淋巴瘤病例数为350例，发病率为每10万人2.97例。弥漫性大B细胞淋巴瘤是最常见的亚型（47.4%），其次是黏膜相关淋巴组织结外边缘区淋巴瘤（32.6%）和滤泡性淋巴瘤（8.3%）。胃是最常见的发病部位（62.6%），其次是大肠（15.4%）、小肠（14.3%）和十二指肠（6.0%）。在纳入的350例病例中，111例通过多指标和/或综合分析确诊，其中FCM分析、细胞遗传学分析和分子分析的阳性结果比例分别为81%、33%和51%。这些结果可能代表了日本胃肠道发生的淋巴瘤情况。对胃肠道相关淋巴瘤进行多指标和/或综合分析能够使我们获得有助于诊断的有用信息。
