原发性胃肠和结内弥漫大B细胞淋巴瘤的临床分析比较  

Clinical analysis and comparison of patients with primary gastrointestinal and nodal diffuse large B-cell lymphoma

作　　者：陈飞[1] CHEN Fei(Department of Hematology,Zhongnan Hospital of Wuhan University,Wuhan,430071,China)

机构地区：[1]武汉大学中南医院血液科,武汉430071

出　　处：《临床血液学杂志》2024年第11期808-811,共4页Journal of Clinical Hematology

摘　　要：目的研究原发性胃肠弥漫大B细胞淋巴瘤(primary gastrointestinal diffuse large B-cell lymphoma,PGI-DLBCL)的临床特征,发现影响患者生存的相关因素。方法收集2020年1月-2022年12月住院的PGI-DLBCL患者临床资料,与结内弥漫大B细胞淋巴瘤(diffuse large B-cell lymphoma,DLBCL)患者对比,统计2组患者的生存,再通过多因素分析研究影响PGI-DLBCL患者生存的因素。结果原发性胃肠淋巴瘤(primary gastrointestinal lymphoma,PGIL)是最常见的原发结外淋巴瘤类型,占所有原发结外淋巴瘤的44.5%(53/119),其中DLBCL占所有PGIL病理类型的69.8%(37/53)。PGI-DLBCL分期Ⅰ~Ⅱ期患者比例为54.1%,明显高于结内DLBCL(16.3%)(P<0.01),PGI-DLBCL诊断时乳酸脱氢酶升高的比例为21.6%,低于结内DLBCL(50.0%)(P<0.01)。PGI-DLBCL患者3年无病生存率为59.5%,明显高于结内DLBCL患者(30.0%)(P<0.01),PGI-DLBCL患者3年总生存率为91.9%,也高于结内DLBCL患者(83.8%),但差异无统计学意义(P>0.05)。结论PGI-DLBCL是最常见的PGIL类型,总体生存优于原发结内DLBCL,可能与确诊时分期较早、乳酸脱氢酶偏低以及治疗反应较好有关。Objective To analyze clinical features and factors affecting the survival of patients with primary gastrointestinal diffuse large B-cell lymphoma(PGI-DLBCL).Methods Clinical data of PGI-DLBCL patients were collected from January 2020 to December 2022,and compared with patients with nodal DLBCL.The factors affecting the survival of PGI-DLBCL patients were analyzed using multivariate analysis.Results Primary gastrointestinal lymphoma was the most common type of primary extranodal lymphoma,accounting for 44.5%(53/119)of all primary extranodal lymphomas,in which PGI-DLBCL accounted for 69.8%(37/53)of all pathologic types of primary gastrointestinal lymphoma.54.1%of patients with PGI-DLBCL were at stageⅠ-Ⅱ,which was higher than that of nodal DLBCL patients(16.3%)(P<0.01).Increased LDH was found in 21.6%of PGI-DLBCL patients,which was lower than that of nodal DLBCL(50.0%)(P<0.01).The 3-year DFS of PGI-DLBCL patients was 59.5%,which was higher than that of nodal DLBCL patients(30.0%)(P<0.01).The 3-year OS of PGI-DLBCL patients was 91.9%,which was higher than that of nodal DLBCL patients(83.8%),but the difference was not significant(P>0.05).Conclusion PGI-DLBCL is the most common type of primary gastrointestinal lymphoma,and the DFS is better than that of nodal DLBCL,which may be due to an earlier disease stage,lower LDH,and better treatment response.

关 键 词：原发性胃肠弥漫大B细胞淋巴瘤 原发性胃肠淋巴瘤 非霍奇金淋巴瘤 临床特征 无病生存 

分 类 号：R733.4[医药卫生—肿瘤]