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[原发性胃肠道淋巴瘤的分期程序]

[Procedures for staging primary gastrointestinal lymphoma].

作者信息

Tedeschi L

机构信息

Ospedale S. Carlo Borromeo, Milano.

出版信息

Riv Eur Sci Med Farmacol. 1994 Sep-Dec;16 Suppl 1:69-74.

PMID:8539468
Abstract

The non-Hodgkin's lymphomas (NHL) are usually generalized diseases and can involve almost any organ or tissue. Nevertheless also primary extranodal disease is frequent in NHL and some localizations are accomplished by a worse prognosis (brain, testicle) other, in particular primary gastrointestinal involvement, can be cured in a high percentage of cases with surgery, chemotherapy and radiotherapy. The gastrointestinal localization's symptomatology is not characteristic: abdominal pain is frequent and other symptoms can be present in other gastrointestinal diseases. Endoscopy, radiology and surgery are the most important diagnostic procedures. The first gives important information about the disease and it permits pre-operative diagnosis. The second is useful to detect both nodal extension (CT scan and MRI imaging) and intrinsic stomach or bowel involvement (contrast radiology of the gastrointestinal tract). The third is an important diagnostic and therapeutic moment. Some Authors recently don't agree with this invasive procedures routinely because of its potential morbidity and mortality. The determination of the extent of disease in patients with NHL is very important and serves multiple purposes: information regarding the imminence of potential complications, indication of prognosis and treatment planning. The most used staging system is the Ann Arbor scheme, originally designed for HG disease. This scheme is inadequate in particular for primary gastrointestinal NHL. Others, like Blackledge or Mushoff schemes show more correlation between tumor burden, nodal and extranodal involvement. An exact diagnosis, precise staging and a correct treatment bring to a potential curability.

摘要

非霍奇金淋巴瘤(NHL)通常是全身性疾病,几乎可累及任何器官或组织。然而,原发性结外疾病在NHL中也很常见,某些部位的预后较差(如脑、睾丸),而其他部位,尤其是原发性胃肠道受累,在很大比例的病例中可通过手术、化疗和放疗治愈。胃肠道受累的症状不具有特异性:腹痛很常见,其他症状也可能出现在其他胃肠道疾病中。内镜检查、放射学检查和手术是最重要的诊断方法。内镜检查可提供有关疾病的重要信息,并有助于术前诊断。放射学检查有助于检测淋巴结转移(CT扫描和MRI成像)以及胃或肠道的内在受累情况(胃肠道造影)。手术既是重要的诊断手段,也是治疗手段。一些作者最近不同意常规进行这种侵入性操作,因为其存在潜在的发病率和死亡率。确定NHL患者的疾病范围非常重要,有多种用途:提供有关潜在并发症紧迫性的信息、指示预后以及制定治疗计划。最常用的分期系统是Ann Arbor分期方案,最初是为霍奇金病设计的。该方案对于原发性胃肠道NHL尤其不适用。其他方案,如Blackledge或Mushoff方案,在肿瘤负荷、淋巴结和结外受累之间显示出更强的相关性。准确的诊断、精确的分期和正确的治疗有望实现治愈。

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