论文部分内容阅读
目的 探讨小肠非霍奇金淋巴瘤的临床特点、诊断、治疗和预后。方法 回顾性分析33例小肠非霍奇金淋巴瘤,其中滤泡型裂细胞性2例,弥漫型裂细胞性7例,弥漫型裂-无裂细胞性5例,弥漫型无裂细胞性6例,免疫母细胞性1例,黏膜相关淋巴组织淋巴瘤2例,弥漫性大B细胞淋巴瘤9例,另有1例为T细胞淋巴瘤。AnnAnbor分期ⅠE期12例,ⅡE期15例,ⅣE期6例。手术治疗33例,2 9例行根治术,另4例行姑息性切除术。2 6例行术后放疗,移动条照射12例,全腹盆腔大野照射14例;中位总剂量2 5 4 3.5cGy。术后化疗33例,其中CHOP方案17例,COMP方案6例,COP方案3例,MINE方案2例,COPP方案3例,BACOP方案2例。结果 5年总生存率和无病生存率分别为4 8%和39% ,中位值分别为4 7、2 3个月。各期的生存率分别为ⅠE期4 2 % ,ⅡE期6 7% ,ⅣE期17%。结论 小肠淋巴瘤多为ⅠE、ⅡE期,病理以中、高度恶性为主,治疗多采用以手术为主的综合治疗,术后放疗及化疗可提高生存率。
Objective To investigate the clinical features, diagnosis, treatment and prognosis of intestinal non-Hodgkin’s lymphoma. Methods A retrospective analysis of 33 cases of small bowel non-Hodgkin’s lymphoma, including follicular cleft cell in 2 cases, diffuse schizoid in 7 cases, diffuse schizophrenia in 5 cases, diffuse non-cancerous cell 6 For example, 1 cases of immunoblastic, 2 cases of mucosa-associated lymphoid tissue lymphoma, 9 cases of diffuse large B-cell lymphoma, and another case of T-cell lymphoma. AnnAnbor stage Ⅰ E period in 12 cases, Ⅱ E period in 15 cases, Ⅳ E period in 6 cases. Surgical treatment of 33 cases, 29 radical mastectomy, the other 4 cases of palliative resection. Twenty-six cases underwent postoperative radiotherapy. Twelve cases were irradiated with moving strips and 14 cases with total abdominal pelvic irradiation. The median total dose was 25.4 3.5 cGy. There were 33 cases of postoperative chemotherapy, of which CHOP regimen 17, COMP regimen 6, COP regimen 3, MINE regimen 2, COPP regimen 3 and BACOP regimen 2. Results The 5-year overall survival and disease-free survival rates were 48% and 39% respectively, with a median of 47.2 and 23 months respectively. Survival rates for each phase were 42% in stage IE, 67% in stage IIE, and 17% in stage IVE. Conclusions Small intestine lymphomas are mostly stage ⅠE and ⅡE. The pathology is mainly medium and high malignant. The treatment is mostly based on the operation-based comprehensive treatment. The postoperative radiotherapy and chemotherapy can improve the survival rate.