摘要
目的探讨原发性小肠淋巴瘤的临床资料、诊断、治疗方法及预后。方法对2011年2月—2019年1月空军军医大学西京消化病医院消化内科收治的原发性小肠淋巴瘤22例患者进行回顾性分析。结果22例患者中,男17例,女5例;年龄15~80岁,中位数58.8岁;常见的临床表现依次为腹痛、贫血、消化道出血、肠梗阻、腹部肿块、肠穿孔、消瘦、腹泻。腹部CT检查22例:单纯小肠占位11例,小肠占位合并不全性肠梗阻3例,单纯不全性肠梗阻4例,肠道穿孔3例,腹腔巨大包块1例。小肠镜检查17例:初步检查准确率为82.3%。肿瘤位于回肠15例,空肠5例,十二指肠2例。病理检查:病理类型均为非霍奇金淋巴瘤,B细胞淋巴瘤20例,T细胞淋巴瘤2例。肿瘤分期:ⅠE期6例,ⅡE期8例,Ⅲ期5例,Ⅳ期3例。外科手术治疗19例:根治性手术13例,姑息性手术6例;术后16例行辅助化疗4~12周期。22例均获得随访,中位随访时间为43个月(2周~108个月);术后1、3、5年生存率分别为77.3%(17/22)、63.6%(14/22)和59.1%(13/22)。结论原发性小肠淋巴瘤临床表现不典型,影像学检查联合小肠镜下活检有助于术前诊断,以外科手术为主的综合治疗可改善患者预后。
Objective To investigate the clinical data,diagnosis,treatment and prognosis of primary small intestinal lymphoma.Methods The article investigated the clinical data,diagnosis,treatment and prognosis of primary small intestinal lymphoma.22 patients with primary small intestinal lymphoma admitted to the Department of Gastroenterology,Xijing Hospital of Digestive Diseases,Air Force Military Medical University from February 2011 to January 2019.Results Among the 22 patients,17 were males and 5 were females;aged 15-80 years,with a median of 58.8 years old;the common clinical manifestations were abdominal pain,anemia,gastrointestinal bleeding,intestinal obstruction,abdominal mass,intestinal perforation,weight loss,diarrhea.There were 22 cases of abdominal CT examination:13 cases of small bowel occupying,7 cases of incomplete intestinal obstruction,3 cases of intestinal perforation,1 case of huge abdominal mass.17 cases of enteroscopy:the accuracy rate of preliminary examination was 82.3%.Tumors were located in 15 cases of ileum,5 cases of jejunum,and 2 cases of duodenum.Pathological examination:pathological types were all non-Hodgkin lymphoma,20 cases of B-cell lymphoma,and 2 cases of T-cell lymphoma.Tumor staging:6 cases were stageⅠE,8 cases were stageⅡE,5 cases were stageⅢ,3 cases were stageⅣ.Surgical treatment of 19 cases:radical surgery in 13 cases,palliative surgery in 6 cases;16 cases of postoperative adjuvant chemotherapy for 4 to 12 cycles.All 22 cases were followed up,with a median follow-up time of 43 months(2 weeks to 108 months);postoperative 1,3,and 5-year survival rates were 77.3%(17/22)and 63.6%(14/22),respectively And 59.1%(13/22).Conclusion The clinical manifestations of primary small intestinal lymphoma are not typical,imaging examination combined with endoscopic biopsy is helpful for preoperative diagnosis,and comprehensive treatment based on surgery can improve the prognosis of patients.
作者
王小娟
刘佳
高欣欣
施育鹏
梁树辉
Wang Xiaojuan;Liu Jia;Gao Xinxin;Shi Yupeng;Liang Shuhui(Department of Gastroenterology,Xijing Hospital of Digestive Diseases,Air Force Medical University,Shaanxi Province,Xi'an 710032,China)
出处
《疑难病杂志》
CAS
2020年第10期1020-1022,1027,共4页
Chinese Journal of Difficult and Complicated Cases
基金
国家自然科学基金面上项目(81571731)。
关键词
小肠淋巴瘤
原发性
诊断
治疗
预后
Small intestinal lymphoma,primary
Clinical diagnosis
Treatment
Prognostic
