Department of Gastroenterology, State key Laboratory of Cancer Biology, National Clinical Research Center for Digestive Diseases and Xijing Hospital of Digestive Diseases, Air Force Medical University, Shaanxi, China.
Department of Medical Insurance, Xijing Hospital, Air Force Medical University, Xi'an, Shaanxi, China.
Saudi J Gastroenterol. 2022 Mar-Apr;28(2):127-134. doi: 10.4103/sjg.sjg_100_21.
In this retrospective study, we investigated the endoscopic and clinical features of patients with EATLs at a tertiary center, from January 2008 to October 2020.
From a total of 248 patients with primary intestinal lymphoma, only 11 patients were finally diagnosed with EATLs, all of which were EATL type II. Men were affected twice as commonly as women. The median patient age was 47 years. The most common initial symptom was diarrhea (63.6%). Five patients (45.4%) were at late stage (IV) at diagnosis. The endoscopic appearances were classified into four distinct types: ulcerative type (54.5%), epithelial mass type (18.2%), diffuse infiltration type (9.1%), and nodular type (18.2%). The small bowel was the most common site of involvement (72.7%). The initial endoscopic impression of lymphoma was made in only 3 patients (27.3%). Only 4 patients (36.4%) were histologically confirmed as having EATLs based on the initial biopsy specimen. Five patients (45.5%) received emergency surgery. The median overall survival (OS) was 8 months. The use of chemotherapy and the absence of emergency surgery were associated with a significantly better median OS (P < 0.05).
EATL may show various endoscopic appearances, and its prognosis is poor. Endoscopists should obtain more knowledge of EATL in order to make an early diagnosis.
本回顾性研究调查了 2008 年 1 月至 2020 年 10 月在一家三级中心就诊的 EATL 患者的内镜和临床特征。
在总共 248 例原发性肠道淋巴瘤患者中,最终仅 11 例被诊断为 EATL,均为 EATL Ⅱ型。男性发病率是女性的两倍。中位患者年龄为 47 岁。最常见的首发症状是腹泻(63.6%)。5 例(45.4%)患者在诊断时处于晚期(Ⅳ期)。内镜表现分为四种不同类型:溃疡型(54.5%)、上皮肿块型(18.2%)、弥漫浸润型(9.1%)和结节型(18.2%)。小肠是最常见的受累部位(72.7%)。仅 3 例(27.3%)患者最初内镜印象为淋巴瘤。仅有 4 例(36.4%)患者根据初次活检标本确诊为 EATL。5 例(45.5%)患者接受了紧急手术。中位总生存期(OS)为 8 个月。化疗的使用和未行紧急手术与中位 OS 显著改善相关(P<0.05)。
EATL 可能表现出多种内镜表现,预后不良。内镜医生应更多地了解 EATL,以便做出早期诊断。