原发性胃肠道恶性淋巴瘤42例分析

The Analysis of 42 Cases of Primary Malignant Lymphoma in Gastrointestinal Tract

目的分析原发性胃肠道恶性淋巴瘤的发病率、治疗方法、疗效及预后。方法对42例原发性胃肠道恶性淋巴瘤的临床资料进行回顾性分析。结果误诊率83.3%。1年生存率88.1%,包括ⅠE20例,ⅡE10例,ⅢE5例,ⅣE2例,第1年死亡5例,均为ⅣE,包括肿物活检术后化疗2例,未化疗3例,其中T细胞型3例,有B症状4例;3年生存率为76.2%,包括ⅠE20例,ⅡE10例,ⅢE2例,均无B症状的病例;5年生存率为59.5%,包括ⅠE19例,ⅡE6例。存活5年以上的病例均为根治性切除术加足程化疗,均为B细胞肿瘤。结论原发性胃肠道恶性淋巴瘤占恶性淋巴瘤的8.94%,占结外淋巴瘤的31.82%,临床极易误诊,根治性手术加足程化疗的病例预后好,分期越早,预后越好,有B症状者预后差,病理类型属T细胞者预后差。

Objective To analyse the incidence rate, treated method, clinical effect and prognosis of primary gastrointestinal malignant lymphoma（PGIML）. Methods The clinical and histopathologie data of 42 patients with PGIML were reviewed and analyzed retrospectively. Resuits The misdiagnostic rate was 83.3%. The 1 year survival rate was 88.1% ,include 20 eases of Ⅰ E,10 eases of Ⅱ E, 5 eases of Ⅲ E, 2 eases of ⅣE, 5 eases died winthin 1 year, they were eases of ⅣE, included 2 eases of chemotherapy after pathological examination, ineluded 3 eases no chemotherapy after pathological examination . Included 3 eases of T cells tumor, included 4 eases with complicated B symptoms. 3-year survival rate was 76.2% , include 20 eases of ⅠE, 10 eases of ⅡE ,2 eases of ⅢE ,they without complicated B symptoms. and 5-year survival rate was 59.5% , including 19 cases of ⅠE ,6 eases of ⅡE. All the patients who survived more than 5-year were those who got radical and chemotherapy. They were eases of B cells tumor. Conclusions PGIML took 8.94% of malignant lymphoma in the same period, took 31.82% of out-lymph node lymphoma. It was easily misdiagnosed. The prognosis of those who got radical and post-operative chemotherapy was better. The prognosis of those who was early stage was better. The prognosis of those complicated with B symptoms or ea- ses of T cells tumor was bad.