摘要
目的原发小肠非霍奇金淋巴瘤（primary small intestinal non—Hodgkin’s lymphoma，PSI-NHL）发病率极低，国内外相关数据较为缺乏。本研究旨在探讨PSbNHL的临床病理特征、治疗方法及预后因素。方法回顾性分析2007—01—01—2014—01—01天津医科大学肿瘤医院收治的67例PSI-NHL患者的临床资料，采用Kaplan-Meier法计算总生存（overall survival，OS）率，行Log—rank检验单因素分析和Cox比例风险模型多因素分析。结果67例患者中男41例，女26例，男女比例为1．58：1，中位年龄55（7～79）岁。病变原发于回肠40例（包括回盲部23例），十二指肠14例，空肠13例。B细胞淋巴瘤55例（82．1％），T细胞淋巴瘤12例（17．9％）。ECOG评分〈255例（82．1％）。根据Lugano分期，早期（Ⅰ～Ⅱ2期）32例（47．8％）。根据国际预后指数（international prognostic index，IPI）评分分组，低危组35例（52．2％），中危组22例（32．8％），高危组10例（14．9％）。67例患者的1、3和5年OS率分别为77．3％、60．5％和50．6％。单因素分析显示，病理类型、肿块大小、Lugano分期、IPI评分、乳酸脱氢酶（lactate dehydrogenase，LDH）水平、低白蛋白血症及治疗方法对预后有影响，均P值〈0．05。多因素分析显示，IPI（P=0．045，95％CI为1．01～4．03）、低蛋白血症（P=0．033，95％CI为1．09～7．35）和治疗方法（P=0．019，95％CI为0．30～0．90）为独立预后因素。各治疗组中，手术联合化疗组的预后最好。结论PSI-NHL发病率低，起病隐匿且临床表现无特异性，以B细胞表型为主，预后显著优于T细胞淋巴瘤。IPI评分、低蛋白血症及治疗方法为影响PSI-NHL生存的独立预后因素。手术联合化疗可作为PSI—NHL的最佳治疗策略。
OBJECTIVE The incidence rate of primary small intestinal non-Hodgkin＇s lymphoma（PSI-NHL） was very low,studies about PSI-NHL at home and abroad had been rather lacking. Our study was to explore the clinicopatho- logical features,treatment and prognostic factors of PSI-NHL. METHODS We retrospectively analyzed the clinical data of 67 PSI-NHL patients during January 1st, 2007 to January 1st, 2014 from Tianjin Medical University Cancer Institute and Hospital. Survival was estimated using Kaplan-Meier curves and was compared between two groups by log-rank test. The Cox proportional hazard regression model was used in multivariate analyses. RESULTS Of the 67 patients, there were 41 males and 26 females,the ratio was 1.58 ： 1 ,with a median age of 55（ranged from 7 to 79） years old. The prima- rily involved location was ileum （40 cases, including 23 cases in ileocecal ）unction）, duodenum （14 cases） and jejunum （13 cases）. There were 55 cases（82.1%） of B cell lymphoma and 12 cases （17.9%） of T cell lymphoma. Totally 55 cases （82.1%）were Eastern Cooperative Oncology Group Performance Status （ECOG PS）〈2.32 cases （47.8%） were stage Ⅰ / Ⅱ disease. International prognostic index （IPI） risk was low in 52.5 % （ 35 cases）, intermediate in 32.8 % （ 22 cases） and high in 14. 9% （10 cases）. The 1-year, 3-year and 5-year survival rates of the patients were 77. 3%, 60. 5% and 50.6 %, respectively. The univariate analysis revealed pathological type, tumor size, Lugano stage, the IPI score, lactate dehydrogenase （LDH） level, serum albumin levels at diagnosis and therapy modality were prognostic factors affecting overall survival （P〈0.05）. The multivariate analysis showed that IPI score （P=0. 045,95%CI was 1.09-7.35） ,the serum albumin levels at diagnosis （P=0. 033,95% was 1.09-7.35） and therapy modality （P=0. 019,95%CI was 0. 30-0. 90） were independent prognostic factors. Among different treatment groups, cases that received surgery combined with
出处
《中华肿瘤防治杂志》
CAS
北大核心
2016年第16期1109-1114,共6页
Chinese Journal of Cancer Prevention and Treatment
关键词
小肠
非霍奇金淋巴瘤
临床特征
预后
small intestine
non-Hodgkin ＇s lymphoma
clinical features
prognosis
