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原发性胃肠道 T 细胞和 NK/T 细胞淋巴瘤的临床、内镜和病理特征。

Clinical, endoscopic and pathological characteristics of primary gastrointestinal T-cell and NK/T-cell lymphomas.

机构信息

Department of Gastrointestinal Endoscopy, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, People's Republic of China.

Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, People's Republic of China.

出版信息

Scand J Gastroenterol. 2023 Feb;58(2):163-169. doi: 10.1080/00365521.2022.2114811. Epub 2022 Aug 28.

Abstract

BACKGROUND AND AIMS

Gastrointestinal T-cell and NK/T-cell lymphomas are relatively rare and may be difficult to diagnose. Therefore, we performed a retrospective study of the clinical, endoscopic and pathological characteristics of these lymphomas, to provide additional data on this issue.

METHODS

From April 2013 to April 2021, consecutive patients diagnosed with primary gastrointestinal T-cell and NK/T-cell lymphomas were retrospectively reviewed. Their medical histories, laboratory, imaging, endoscopic, and pathology results were analyzed.

RESULTS

Forty-two patients were finally chosen, among whom, 24 patients had ENKTCL, 9 patients had MEITL, 2 patients had ALCL, ALK-, 1 patient had ALCL, ALK+, and 6 patients had PTCL, NOS. The median age of all the patients was 48 years old, and 73.81% (31 patients) were male. The patients' symptoms were abdominal pain, diarrhea, gastrointestinal bleeding, weight loss, fever, and others. The endoscopic results of 26 patients could be traced, and 69.23% of the patients showed multiple lesions. Ulcerative and ulceroinfiltrative lesions were common. Among the pathologic findings, necrosis, ulceration, and crypt atrophy were commonly found while epitheliotropism was relatively less common. Twelve patients (28.57%) had a history of misdiagnosis. After a median follow-up time of 26.9 months, 26 patients (66.70%) died of the disease. The median overall survival time was 8 months.

CONCLUSIONS

These lymphomas had nonspecific clinical manifestations, various endoscopic features, and were likely to be misdiagnosed as other diseases. The prognosis is still poor, and more in-depth research is needed to develop more precise treatments.

摘要

背景与目的

胃肠道 T 细胞和 NK/T 细胞淋巴瘤相对少见,可能难以诊断。因此,我们对这些淋巴瘤的临床、内镜和病理特征进行了回顾性研究,以提供该问题的更多数据。

方法

从 2013 年 4 月至 2021 年 4 月,连续回顾性分析了诊断为原发性胃肠道 T 细胞和 NK/T 细胞淋巴瘤的患者。分析了他们的病史、实验室、影像学、内镜和病理结果。

结果

最终选择了 42 名患者,其中 24 名患者患有 NK/T 细胞淋巴瘤,9 名患者患有结外鼻型 NK/T 细胞淋巴瘤,2 名患者患有间变大细胞淋巴瘤,ALK-,1 名患者患有间变大细胞淋巴瘤,ALK+,6 名患者患有外周 T 细胞淋巴瘤,NOS。所有患者的中位年龄为 48 岁,73.81%(31 名患者)为男性。患者的症状有腹痛、腹泻、胃肠道出血、体重减轻、发热等。可追踪到 26 名患者的内镜结果,69.23%的患者表现为多发病变。常见的内镜表现为溃疡性和溃疡浸润性病变。在病理表现中,常见坏死、溃疡和隐窝萎缩,上皮嗜性相对较少见。有 12 名患者(28.57%)有过误诊史。在中位随访 26.9 个月后,26 名患者(66.70%)死于该病。中位总生存时间为 8 个月。

结论

这些淋巴瘤临床表现不特异,内镜表现多样,容易误诊为其他疾病。预后仍然较差,需要更深入的研究来开发更精确的治疗方法。

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