原发于胃肠道非霍奇金淋巴瘤116例预后因素探讨  

Prognostic fator analysis of 116 cases of primary gastrointestinal non-Hodgkin's lymphoma

作　　者：林显敢[1] 黄开红[2] 谢德荣[1] 刘天浩[1] 

机构地区：[1]中山大学附属第二医院肿瘤科,广东广州510120 [2]中山大学附属第二医院消化内科,广东广州510120

出　　处：《南方医科大学学报》2008年第2期243-245,共3页Journal of Southern Medical University

基　　金：广州市科技攻关项目(2003Z3-E0351);国家自然科学基金(30670951);广东省自然科学基金(06021322)

摘　　要：目的探讨影响原发性胃肠道非霍奇金淋巴瘤患者的预后因素。方法回顾分析本院1993年1月-2003年12月收治的经病理证实的116例原发性胃肠道非霍奇金淋巴瘤患者的临床资料。应用Kaplan-Meier法进行生存分析,组间比较用Log-rank检验,多因素分析采用Cox模型进行分析。结果本组病例3、5年生存率分别为63.8%（74/116）和48.2%（40/83）。单因素分析结果显示,有无B症状、肿块大小、临床分期、病理分型、肿瘤浸润深度、治疗模式是影响患者预后的因素。伴随B症状、肿块≥10cm、临床分期ⅢE-ⅣE期、T细胞型、肿瘤突破浆膜层者的预后较无B症状、肿块〈10cm、临床分期ⅠE-ⅡE期、B细胞型、肿瘤未突破浆膜层者差。多因素分析显示,肿块≥10cm、临床分期ⅢE-ⅣE期、T细胞型、单纯手术者预后差。结论肿瘤大小、临床分期、病理分型及治疗模式是影响原发性胃肠道非霍奇金淋巴瘤患者预后的独立危险因素。Objective To investigate the factors that affect the prognosis of primary gastrointestinal non-Hodgkin＇s lymphoma （PGI-NHL）. Methods The clinical data of 116 patients with pathologically confirmed PGI-NHL we treated from January 1993 to December 2003 were analyzed retrospectively, Kaplan-Meier survival analysis was used for analyzing the survival of the patients, and Log-rank test was performed to compare the survival rates in relation to different prognostic factors. Results The 3-year and 5-year survival rates of the patients were 63.8% （74/116） and 48.2% （40/83）, respectively, Univariate analysis revealed that the factors affecting the prognosis of the patients included the presence of B symptom, tumor size, clinical stage, pathological type, depth of invasion, and treatment methods. The patients with B symptom, tumor size no less than 10 cm, advanced clinical stage （stages ⅢE and ⅣE）, T-cell type, and invasion beyond the serosa who received only surgical management had poorer prognosis than those flee of B symptom with tumor size 〈10 cm, early clinical stage （stages ⅠE and ⅡE）, B-cell type, and submucosal or serosal invasion managed with chemotherapy alone or in combination with surgery. Multivariate analysis showed that B symptom, tumor size no less than 10 cm, advanced clinical stage （stages ⅢE and ⅣE）, T-cell type, invasion beyond the serosa, and surgery alone were independently associated with poor prognosis. Conclusion The tumor size, clinical stage, pathological type, treatment methods are the independent factors affecting the prognosis of patients with PGI-NHL.

关 键 词：胃肠肿瘤 非霍奇金淋巴瘤 预后 

分 类 号：R735[医药卫生—肿瘤]