原发性肠道淋巴瘤的研究进展

Progress of primary intestinal lymphoma

原发性肠道淋巴瘤（PIL）在原发消化道淋巴瘤（PGIL）中的发生率略低于原发性胃淋巴瘤（PGL），其中PGL的治疗模式已经规范化，而PIL的诊断、治疗仍存在很大争议。病变局限于肠道，或主要病变在肠道，关于PIL的定义尚无统一的标准。PIL最常见的部位是回盲部，病理类型以B细胞来源为主，其中弥漫大B细胞淋巴瘤最为常见，其次是黏膜相关淋巴组织型边缘区B细胞淋巴瘤。抗生素治疗、手术、化疗、放疗、单克隆抗体等可作为单一治疗或联合治疗，在PIL中也尚无定论，且影响预后的因素较多。现对其诊断标准、临床特征、最佳的治疗方式及预后因素，重点在于其诊断标准及最佳的治疗方式进行综述。

The incidence of primary intestinal lymphoma （PIL） in primary gastrointestinal lymphoma （PGIL） is much lower than that of primary gastric lymphoma （PGL）. Treatment strategies for PGL have been normalized, but there are still controversies concerning about the diagnosis criteria and optimal treatment of P1L. The lesions are mainly found in intestinal tract, and the most common involvement is ileoeecal junction. The pathological types are derived from B-cell and diffuse large B-cell lymphoma （DLBCL） is the most common type, followed by extra-nodal marginal zone lymphoma of mucosa-associated lymphoid tissue. Surgery, chemotherapy, radiotherapy, antibiotics and monoclonal antibody therapy could be used as the monotherapy or different combined therapies, however, the final conclusion has not been reached in the treatment of PIL, accompanied by various influencing factors for prognosis. This review discusses the diagnosis criteria, clinical features, optimal treatment and prognostic factors of PIL. The diagnosis criteria and the optimal treatment will be put more emphasis.