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目的 了解我国肠道T细胞淋巴瘤 (ITCL)的预后情况 ,探讨不同临床病理因素和EB病毒基因产物对其预后的影响 ,以期寻找确切的预后指标。方法 收集 4 2例ITCL ,运用免疫组织化学LSAB法染色观察CD4、CD8、CD4 5RO、CD5 6、TIA 1和EB病毒潜伏膜蛋白 (LMP 1)的表达 ,采用聚合酶链反应 (PCR)检测TCR γ基因重排扩增 ,运用EBER1/2原位杂交检测EB病毒感染。收集全部 4 2例ITCL的临床资料并进行随访。应用SPSS10 0软件分析临床病理、免疫表型及EB病毒基因产物各项指标与治疗及生存率曲线的关系。结果 (1) 4 2例ITCL中有随访结果者 2 9例 (6 9% )。存活 6例 ,最长存活时间 15 6个月 (13年 )。死亡 2 3例 ,其中复发 4例 ,存活时间 0 3～ 2 4 3个月 ,存活时间中位数3 0个月 ,1年生存率和 2年生存率分别为 30 %和 2 2 %。 (2 )在病灶为单发或多发 ,患者是否出现发热、便血、肠穿孔、淋巴结转移等临床表现 ,肿瘤细胞是否表达CD4、CD8、CD5 6、LMP 1,有无TCR γ基因重排、手术治疗后是否合并化疗或放疗等其他治疗方法各因素中 ,除TCR γ基因重排 (P =0 0 0 78,)和不同的治疗方法 (P =0 0 2 5 0 )外 ,其他各因素与预后不相关。 (3)没有发现有意义的预后因素。结论 肠道T细胞淋巴瘤临床进程凶猛、预后差的特殊表
Objective To understand the prognosis of intestinal T-cell lymphoma (ITCL) in China and explore the influence of different clinicopathological factors and Epstein-Barr virus (EBV) gene products on its prognosis in order to find out the exact prognostic indicators. Methods Twenty-two cases of ITCL were collected and the expression of CD4, CD8, CD4 5RO, CD5 6, TIA 1 and Epstein-Barr virus latent membrane protein (LMP 1) were detected by immunohistochemical staining with LSAB method. TCR was detected by polymerase chain reaction γ gene rearrangement amplification EBR1 / 2 in situ hybridization detection of Epstein-Barr virus infection. The clinical data of all 42 ITCL cases were collected and followed up. The relationship between clinical pathology, immunophenotype, Epstein-Barr virus gene products and treatment and survival curves was analyzed by SPSS10 software. Results (1) There were 29 follow-up cases (69%) in 42 ITCL cases. Survival in 6 cases, the longest survival time of 15 6 months (13 years). There were 23 deaths, of which 4 were recurrences. The survival time ranged from 0 to 24 months. The median survival time was 30 months. The 1-year and 2-year survival rates were 30% and 22% respectively. (2) whether the patients showed fever, blood in the stool, intestinal perforation, lymph node metastasis and other clinical manifestations when the lesions were single or multiple, whether the tumor cells expressed CD4, CD8, CD5 6, LMP 1, with or without TCR γ gene rearrangement, Among the factors of other treatment methods, such as chemotherapy or radiotherapy, whether or not TCR γ gene rearrangement (P = 0 0 0 78) and different treatment methods (P = 0 0 2 5 0), other factors Prognosis is not related. (3) No significant prognostic factors were found. Conclusion The clinical progress of intestinal T-cell lymphoma is fierce and the prognosis is poor