101例原发胃肠道非霍奇金淋巴瘤临床及预后分析

摘要

本研究旨在探讨原发胃肠道非霍奇金淋巴瘤(primary gastrointestinal non-Hodgkin's lymphoma,PGI-NHL)的临床特征及预后生存因素.对本院15年来收治的101例原发胃肠道非霍奇金淋巴瘤病例资料进行回顾性分析,结果显示:101例PGI-NHL病例占同期NHL的14.49％,其中男性64例,女性37例,男∶女=1.73∶1,中位发病年龄61(18-87)岁；发病部位:胃部59例(58.42％),肠道40例(39.60％),胃肠道多部位2例(1.98％)；弥漫大B细胞淋巴瘤(DLBCL) 67例(66.34％)、黏膜相关组织(MALT)淋巴瘤18例(17.82％)、套细胞淋巴瘤(MCL)4例(3.96％)、肠病相关T细胞淋巴瘤(EATL)8例(7.92％)、结外鼻型NK/T细胞淋巴瘤2例(1.98％)、滤泡细胞淋巴瘤(FLL)1例(0.99％)、小淋巴细胞淋巴瘤(SLL)1例(0.99％).在101例患者中可随访89例(存活49例,死亡40例),中位生存时间29(1-173)个月.89例患者的3年总生存率(OS)为58.4％,5年为52.6％；单因素分析显示,性别(P=0.004)、病变部位(P =0.002)、病变大小(P=0.011)、胃肠道淋巴瘤Lugano分期(P=0.003)、IPI评分(P=0.000)、病理细胞表型(P=0.000)、病理类型(P =0.006)等因素在不同亚组OS差异有统计学意义.多因素分析显示,影响OS的独立危险因素为胃肠道淋巴瘤Lugano分期、IPI评分和病理类型.结论:胃肠道淋巴瘤Lugano分期、IPI评分和病理类型是影响总生存的独立危险因素.%This study was purposed to analyze the clinical characteristics and prognostic factors in patients with primary gastrointestinal non-Hodgkin's lymphoma (PGI-NHL). The pathological data of 101 PGI-NHL patients admitted in our hospital in the past 15 years were analyzed retrospectively. The results showed that 101 patients with PGI-NHL accounted for 14.49% of NHL in the same period, there were 64 males, 37 females, the range of ages was from 18 to 87 years old, median age was 61 years old; in disease distribution, the stomach PGI-NHL accounted for 58. 42% , intestine PGI-NHL accounted for 39. 60% , multiple GI involvements (MGI) accounted for 1. 98% ; in pathological type, diffuse large B cell lymphoma (DLBCL) accounted for 66. 34% , mucosa-associated lymphoid tissue (MALT) lymphoma accounted for 17. 82% , mantle cell lymphoma (MCL) accounted for 3. 96% , enteropathy-associated T cell lymphoma (EATL) accounted for 7. 92% , extra-nodal nasal type NK / T cell lymphoma accounted for 1. 98% , follicular lymphoma (FL) accounted for 0. 99% , small lymphocyte lymphoma (SLL) accounted for 0. 99% . Eighty-nine out of 101 patients were followed up (49 cases live, 40 cases dead), data of the 12 patients were lost; the median survival time was 29 months (1 - 173). The three-year OS and five-year OS were 58.4% and 52. 6% respectively. Univariate analysis revealed that the factors affecting OS included sex (P = 0. 004), lesion site (P = 0.002), tumor size (P = 0. 011), clinical Lugano staging for gastrointestinal non-Hodgkin' s lymphoma ( P = 0.003), IPI score ( P = 0.000), pathological cell phenotype (P = 0. 001 ), and pathological type (P = 0. 006 ), their differences were statistically significant (P < 0. 05). Multivariate Cox regression analysis indicated that clinical Lugano staging for gastrointestinal non-Hodgkin's lymphoma, IPI score, pathological type were independent prognostic risk factors affecting OS. It is concluded that clinical Lugano staging for gastrointestinal non-Hodgkin's lymphoma, IPI score and pathological type are independent risk factors affecting OS.