Li X Y, Yao J N, Dong X Y, Cheng L X, Zhang X X, Su M G, Zhou H N, Xie J L, Song Z X, Han F
Department of Gastroenterology, the First affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.
Zhonghua Zhong Liu Za Zhi. 2024 Aug 23;46(8):782-793. doi: 10.3760/cma.j.cn112152-20231026-00260.
To investigate the clinical manifestations, endoscopic characteristics, and prognostic factors of patients with colorectal extranodal NK/T cell lymphoma. The clinical data of 52 patients with colorectal extranodal NK/T cell lymphoma admitted to the First Affiliated Hospital of Zhengzhou University from January 2013 to January 2023 were retrospectively analyzed. Their clinical manifestations and endoscopic characteristics were summarized, and the prognostic factors were analyzed by Cox regression model. Among the 52 patients with colorectal extranodal NK/T cell lymphoma, there were 35 males and 17 females, with a male-to-female ratio of 2.06∶1. Among the general symptoms, abdominal pain was the most common (39 cases), and B symptoms occurred in 47 patients, among which fever was the most common lymphoma B symptom (42 cases), and gastrointestinal perforation was the most common complication (18 cases). Forty-three patients underwent colonoscopy, and the main manifestations under endoscopy were the ulceration type (24 cases). The ulcers were irregular at the edges and often covered with moss at the bottom. The median survival time was 4.3 months. Multivariate Cox regression analysis showed that hemocytic syndrome (=8.50,95% : 1.679-8.328,=0.001), serum albumin (=3.59,95% : 1.017-6.551, =0.048), and with or without chemotherapy (=0.31, 95% : 0.246-1.061, =0.025) were independent factors influencing the overall survival of patients with colorectal extranodal NK/T cell lymphoma. Colorectal extranodal NK/T cell lymphoma is a rare disease with a very poor prognosis. When patients present with abdominal pain and lymphoma B symptoms, and when ulcers with irregular edges and moss covering the bottom are found under endoscopy, the disease should be considered, and endoscopic biopsy should be taken in time for pathological diagnosis. The prognosis of patients with hemophagocytic syndrome and hypoproteinemia is poor. This disease should be treated with chemotherapy and surgery, and on this basis, hemophagocytic syndrome and hypoproteinemia should be treated to improve the prognosis of patients.
探讨结直肠结外NK/T细胞淋巴瘤患者的临床表现、内镜特征及预后因素。回顾性分析2013年1月至2023年1月郑州大学第一附属医院收治的52例结直肠结外NK/T细胞淋巴瘤患者的临床资料。总结其临床表现及内镜特征，并采用Cox回归模型分析预后因素。52例结直肠结外NK/T细胞淋巴瘤患者中，男性35例，女性17例，男女比例为2.06∶1。一般症状中，腹痛最为常见（39例），47例出现B症状，其中发热是最常见的淋巴瘤B症状（42例），胃肠道穿孔是最常见的并发症（18例）。43例患者接受了结肠镜检查，内镜下主要表现为溃疡型（24例）。溃疡边缘不规则，底部常覆有苔。中位生存时间为4.3个月。多因素Cox回归分析显示，血细胞综合征（=8.50，95%：1.679 - 8.328，=0.001）、血清白蛋白（=3.59，95%：1.017 - 6.551，=0.048）以及是否接受化疗（=0.31，95%：0.246 - 1.061，=0.025）是影响结直肠结外NK/T细胞淋巴瘤患者总生存的独立因素。结直肠结外NK/T细胞淋巴瘤是一种罕见病，预后很差。当患者出现腹痛及淋巴瘤B症状，且内镜下发现边缘不规则、底部覆有苔的溃疡时，应考虑该病，并及时行内镜活检进行病理诊断。伴有噬血细胞综合征及低蛋白血症的患者预后较差。本病应采用化疗及手术治疗，在此基础上，应对噬血细胞综合征及低蛋白血症进行治疗以改善患者预后。
