摘要
目的 :探讨原发胃肠道恶性淋巴瘤 (PGIML)的临床特点、病理性质及其与预后的关系。方法 :回顾性研究 1978～ 1998年收治的 5 3例PGIML临床特征、病理诊断及治疗。结果 :5 3例PGIML中 ,胃ML38例 ,肠ML15例 ,Ⅰ期 10例 ,Ⅱ期 33例 ,Ⅲ期 7例 ,Ⅳ期 3例。最常见症状为腹痛、腹胀、食欲低下 ,有B症状者 5例 ,2例霍奇金病 (HD) ,5 1例非霍奇金淋巴瘤 (NHL)。B细胞来源 4 8例 ,T细胞来源3例。MALT淋巴瘤 2 9例。Ⅰ、Ⅱ期患者行根治性手术切除 ,术后加化疗 ,未行手术及Ⅲ、Ⅳ期患者行化疗。随访资料完整 4 0例。Ⅰ、Ⅱ期 5年生存率为 78.1% ,Ⅲ、Ⅳ期为 12 .5 % (P <0 .0 0 1)。结论 :PGIML临床表现无特异性 ,Ⅰ、Ⅱ期患者采用手术为主的综合治疗 ,Ⅲ、Ⅳ期患者采用化疗为主的综合治疗 。
Objective:To explore the clinic and pathologic characteristics of PGIML (primary gastrointestnal malignant lymphoma) and discuss the prognostic factors.Methods:The clinical features,diagnosis and treatment of 53 patients with PGIML between 1978 and 1998 were retrospectively analyzed.Results:Among 53 cases,there were 38 stomach ML,15 intestine ML.The Ann Arbor stages were:stage Ⅰ,10 patients;stage Ⅱ,33 patients;stage Ⅲ 7 patients;stage Ⅳ ,3 patients.The most common symptoms included abdominal pain,abdominal swelling and loss of weight.Only 5 patients had B symptoms.There were Only 2 Hodgkin’s disease,and other 51 cases were non-Hodgkin’s lymphoma.48 cases were B-cell lymphoma,3 T-cell,29 cases were mucosa-associated lymphoid-tissue(MALT).The patients in stage Ⅰ、Ⅱ received radical resection and combined with chemotherapy after resection,and those without operation and in stage Ⅲ、Ⅳ only received chemotherapy.Among 40 patients with complete follow-up files,the 5-year survival rates were 78.1% in stage Ⅰ、Ⅱ,12.5% in stage Ⅲ、Ⅳ.There were significant differences between 2 goups(P<0.001).Conclusion:PGIML had no specifical clinical features.The patients in stage Ⅰ、Ⅱ received systematic treatment on the base of operation and those in stage Ⅲ、Ⅳ mainly received chemotherapy.Clinical stage is a strong predictor of prognosis.
出处
《中国现代普通外科进展》
CAS
2004年第5期309-309,311,共2页
Chinese Journal of Current Advances in General Surgery
关键词
胃肠肿瘤
淋巴瘤
Gastrointestinal neoplasms·Lymphoma
