摘要
目的 探究原发胃肠道弥漫性大B细胞淋巴瘤(PGI-DLBCL)的病例特点,并比较不同病例特点与疗效的关系。方法 回顾性分析2013年12月—2020年12月桂林医学院附属医院收治的49例PGI-DLBCL患者的临床特征、病理特点及对治疗反应,并进行回顾性分析。结果 49例患者中男性26例(53.1%),女性23例(46.9%);中位年龄59.5岁(18-81)岁,其中≥60岁25例(51.0%)。按Ann Arbor分期Ⅰ期7例(14.3%),Ⅱ期20例(40.8%),Ⅲ期14例(28.6%),Ⅳ期8例(16.3%),含B组症状的21例(42.9%),IPI PS≤2分22例(44.9%),IPI PS>2分27例(55.1%)。按病灶来源分类,发生在胃部31例(63.3%),小肠4例(8.2%),回盲部1例(2.0%),大肠10例(20.4%),累及≥2个部位3例(6.1%)。17例(34.7%)为生发中心来源(GCB型),32例(65.3%)为非生发中心来源(non-GCB),BCL-2蛋白阳性患者38例(77.6%),BCL-6蛋白阳性患者35(71.6%),C-MYC≥40%阳性的患者15例(30.6%),Ki-67≥70%者27例(55.1%)。43例完成4疗程化疗,14例达CR,21例达PR,5例SD,3例PD。37例完成6疗程化疗,28例达CR,5例PR,1例SD,3例PD。分期为早期(Ⅰ+Ⅱ)(P<0.01),无B症状(P<0.01),C-MYC阳性<40%(P<0.01)及化疗方案中使用利妥昔单抗(P<0.01)的治疗缓解率高。结论 PGI-DLBCL病灶胃部多见,non-GCB类型及C-MYC、BCL-2、BCL-6高表达多见,初诊时的分期、B症状、C-MYC及治疗方案中未含R均是影响治疗效果的因素。
Objective To investigate the clinical manifestation, immunophenotypes and prognostic characteristics of patients with primary gastrointestinal diffuse large B-cell lymphoma(PGI-DLBCL).Methods The clinical data including clinical characterstics, typing, staging, treatment efficacy factors of 49 patients who were newly diagnosed as PGI-DLBCL in Affiliated Hospital of Guilin Medical University from December 2013 to December 2020 were collected and analyzed restrospectively.Results Among the 49 patients with PGI-DLBCL,26 males to 23 females;median age was 59.5 years(18~81 years).Among all patients, 7(14.3%)cases were Ann Arbor stage Ⅰ, 20(40.8%) in stageⅡ,14(28.6%) in stage Ⅲ,8(16.3%)in stage Ⅳ,and there were 21(42.9%) patients with B symptom, 22(44.9%)patients were IPI PS≤2, 27(55.1%) patients were IPI PS>2.31(63.3%),17(34.7%) cases of germinal center type B-cell(GCB) and 32(65.3%)of non-germinal center type(non-GCB), 38(77.6%)cases were in BCL-2 protein positive, 35(71.6%)cases in BCL-6 protein positive, 15(30.6%)cases were in C-MYC≥40% positive and 27(55.1%)cases in Ki-67≥70% positive. After teatment for 4 cycles, 43 patients were evaluated. Among them 14 cases reached to complete remission(CR), 21 cases to partial remission(PR), 5 cases to stable remission(SD),3 cases progressive disease(PD). After teatment for 6 cycles, 37 patients were evaluated. Among them 28 cases reached to complete remission(CR), 5 cases to partial remission(PR), 1 cases to stable remission(SD),3 cases progressive disease(PD). The patients were early period, without B symptom, C-MYC negative and use rituximab(R) in the treatment received high remission(P<0.05).Conclusion Most PGI-DLBCL patients comes from stomach, PGI-DLBCL patients were in high express C-MYC,BCL-2 protein and BCL-6 protein, also, a large percentage PGI-DLBCL were non-GCB type.The patients have a good efficacy in early stage, no B symptom, negative C-MYC protein and using R in therapy.
作者
吴贤义
邓桃花
徐淑娟
田佳
林文远
WU Xian-yi;DENG Tao-hua;XU Shu-juan;TIAN Jia;LIN Wen-yuan(Department of Hematological,Guilin Medical University,Guilin 541001,China;Department of Geriatrics,Afiliated Hospital of Guilin Medical University,Guilin 541001,China;Department of Pathology,Affiliated Hospital of Guilin Medical University,Guilin 541001,China)
出处
《医药论坛杂志》
2022年第18期13-17,共5页
Journal of Medical Forum
基金
广西壮族自治区卫生健康委员会自筹经费科研课题(Z20190628)。
关键词
胃肠道
结外弥漫大B细胞淋巴
免疫表型
疗效
Gastrointestinal
Extranodal diffuse large B cell lymphoma(DLBCL)
Immunophenotype
Efficacy
