Objective To analyze the clinicopathological characteristics and prognostic factors in patients with primary intestinal diffuse large B-cell lymphoma (DLBCL).Methods Clinical manifestation,pathological feature,diagnosis,therapeutic strategy and the relevant prognostic factors of 27 patients with primary intestinal DLBCL were retrospectively analyzed.Kaplan-Meier method was performed for survival analysis.Log-rank test was used for univariate analysis and the Cox proportional hazard regression model was used in multivariate analysis.Results The median age of 27 patients was 61 years old (15-83),and male:female ratio was 1.08∶ 1.The most common site of primary intestinal DLBCL was ileum,followed by ileocecal,cecum,jejunum.Abdominal pain was the most common clinical manifestation of DLBCL.The diagnosis mainly depended on endoscopy and postoperative pathology.The center B cell-like (GCB) group had 19 patients and non GCB groups had 8 patients.The 1 year and 3 year overall survival (OS) rates were 64.3％ and 39.3％,respectively.Univariated analysis revealed that the factors affecting prognosis of primary intestinal DLBCL patients included age,the level of LDH and CA 125,tumor size,CD 1 0,Bcl-6,international prognostic index (IPI) score and Ann Arbor staging (all P ＜ 0.05).Multivariate analysis of Cox proportional hazard regression model showed no independent prognostic factors.Conclusions Primary intestinal DLBCL was highly invasive and heterogeneous.There were many factors affecting prognosis,which was of great significance to the diagnosis and treatment of this disease.%目的 探讨原发性肠道弥漫性大B细胞淋巴瘤(DLBCL)的临床病理特征及预后因素.方法 回顾性分析27例DLBCL患者的临床表现、病理特点、诊断治疗及预后.采用Kaplan-Meier法进行生存分析.采用Log-rank检验进行单因素分析,采用Cox回归模型进行多因素分析.结果 27例患者的年龄15～83岁,中位年龄为61岁,男女比例为1.08∶1,最常见的发病部位为回肠,其次为回盲部、盲肠、空肠.腹痛为原发性肠道DLBCL最常见的临床表现,诊断主要依靠于内镜及术后病理.其中生发中心型(GCB) 19例,non-GCB型8例.患者1年、3年总生存率为64.3％、39.3％.单因素分析显示影响预后因素包括:年龄、LDH水平、CA125水平、肿块大小、CD10、Bcl-6、国际预后指数(IPI)评分及Ann Arbor分期(均P＜0.05).Cox回归模型多因素分析未见独立预后不良因素.结论 原发性肠道DLBCL具有高度侵袭性及异质性,预后影响因素众多,对该类疾病临床诊治具有较大意义.
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