原发结肠恶性淋巴瘤35例临床特征及预后分析  

Clinical features, diagnosis, treatment and prognosis of 35 patients with primary colonic malignant lymphoma

作　　者：张婷婷 田丰[1] ZHANG Ting-ting;TIAN Feng(Department of Gastroenterologyj Shengjing Hospital Affiliated to China Medical University,Shenyang 110004p China)

机构地区：[1]中国医科大学附属盛京医院消化内科,辽宁沈阳110004

出　　处：《中国实用内科杂志》2018年第9期840-843,共4页Chinese Journal of Practical Internal Medicine

基　　金：2017年辽宁省高等学校基本科研项目(LFWK201707)

摘　　要：目的探讨原发结肠恶性淋巴瘤(primary colon malignant lymphoma,PCML)的临床特征、诊治方法及预后。方法回顾性分析2010年1月至2017年5月在中国医科大学附属盛京医院确诊的结肠恶性淋巴瘤患者的病例资料。分析患者临床特征、辅助检查、病理特征及治疗,对比分析不同因素对患者预后的影响。结果确定符合条件的原发结肠恶性淋巴瘤患者35例,其中男20例,女15例;年龄(66.26±11.69)岁(40~86岁)。最常见的临床表现为:腹痛21例(60.0%)、腹胀19例(54.29%)和腹部包块16例(45.71%)。病变部位:回盲部14例(40%),结肠11例(31.43%),直肠7例(20.0%),多部位3例(8.57%)。经手术确诊为30例(85.71%),经肠镜活检后确诊5例(14.29%)。所有患者均为非霍奇金淋巴瘤(non-Hodgkin’s lymphoma,NHL),B细胞来源30例(85.71%),其中弥漫大B细胞型22例(62.85%)最常见;T细胞来源5例(14.29%)。32例(91.43%)患者接受外科手术治疗,19例(54.29%)接受全身化疗;单纯手术治疗16例(45.71%),手术联合化疗16例(45.71%),单纯化疗2例(5.71%),化疗联合放疗1例(2.86%)。中位生存时间25个月。结论结肠恶性淋巴瘤好发于男性,腹痛、腹胀及腹部包块是常见的临床表现,病变部位回盲部及右半结肠最常见。最常见的病理类型是弥漫大B细胞型。Objective To investigate the clinical features, diagnosis, treatment methods and prognosis of primary colonic malignant lymphoma （PCML）. Methods Totally 35 patients with PCML admitted from January 2010 to May 2017 were analysed retrospectively. The clinical features, auxiliary examinations, pathological features and treatment of patients were analyzed, and the prognostic effects of different factors were analyzed. Results Totally 35 patients with PCML were identified, including 20 males and 15 females. Age 66.26＋11.69 years old （40-86 years old）. The three of the most common clinical manifestations were abdominal pain, accounted for 60%, abdominal distension, accounting for 54.29%, and abdominal mass, accounting for 45.71%. Lesion site： There were 14 cases ofileocectal blindness （40%）, 11 cases of colon （31.43%）, 7 cases of rectum （20%） and 3 cases of multiple sites （8.57%）.. The diagnosis was confirm in 30 cases （85.71%） by surgery; and 5（14.29%） by enteroscopic biopy. All patients were NHL. There were 30 cases of B-cells lymphoma （85.71%）, of which 22 cases （62.85%） were diffuse large B-cell lymphoma, and 5 cases （14.29%） were T-cell lymphoma.Surgical treatment in 32 （91.43%） cases. Systemic chemotherapy in 19 cases （54.29%）, surgery alone in 16 cases （45.71%）. Operation combined with chemotherapy in 16 cases （45.71%）, Chemotherapy alone in 2cases（S.71%） and chemotherapy combined with radiotherapy in lcase （2.86%）. Median survival time was 25 months. Conclusion Malignant lymphoma of the colon is very common in men. Abdominal pain, abdominal distension and abdominal mass are common clinical manifestations. Ileocecum and the right colon are the most common lesion sites. The most common pathological type is diffuse large B-cell type.

关 键 词：结肠恶性淋巴瘤 非霍奇金淋巴瘤 临床特征 

分 类 号：R735.35[医药卫生—肿瘤]