原发胃肠道弥漫性大B细胞淋巴瘤的预后分析

Prognostic analysis of primary gastrointestinal diffuse large B-cell lymphoma

目的 对原发胃肠道弥漫性大B细胞淋巴瘤（PGI-DLBCL）的特征、治疗和预后进行探讨.方法 回顾性分析2003年至2007年收治的20例PGI-DLBCL患者的临床特征、肿瘤分子分型和治疗方式,并对生存率和预后等相关因素进行统计学分析.结果 所有患者平均总生存期为42～52个月,无进展生存期为37～47个月.国际评分指数（IPI）为0～2分和＞2分时对患者的预后具有提示作用.在原发胃或原发肠道淋巴瘤患者中,分子病理类型[发生中心（GCB型）和非GCB型]对患者的预后无显著的提示意义.利妥昔单抗联合化学治疗（R-CHOP）与单用化学治疗（CHOP）对患者预后的影响差异无统计学意义（P＞0.05）,而手术切除病灶可能对长期生存有利.结论 PGI-DLBCL的最佳治疗方式可能不同于其他部位的DLBCL,还需要大样本的病例进行对照分析.

Objective To assess the clinical characteristics of primary gastrointestinal diffuse large B-cell lymphoma （PGI-DLBCL） and its treatment and prognosis. Methods Twenty patients diagnosed with PGI-DLBCL were admitted to hospital between 2003 and 2007. The clinical characteristics and tumor molecular model of PGI-DLBCL as well as therapeutic methods were retrospectively studied. The factors that related to survival and prognosis were statistically analysed.Results The overall survival （OS） time of the patients were from 42 months to 52 months,while the progression-free survival （PFS） time were from 37months to 47 months. The International Prognostic Index （IPI） score （0～2 or ＞2） played a reminding role in prognosis of the disease. Tumor molecular model was no effect on prognosis [that was no significant difference between germinal center B-cell-like （GCB） type and non-GCB type]. The efficacy of Rituximab in combination with CHOP chemotherapy （R-CHOP） in treatment of PGI-DLBCL was similar to CHOP chemotherapy alone, whereas surgical intervention might prolong survival period. Conclusions The biological characteristics of PGI-DLBCL is so particular that the most therapeutic method, which need to be further studied, would be different from DLBCL in other position.