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目的:分析肠道结外鼻型NK/T细胞淋巴瘤患者的临床特点,以提高对该疾病的认识及诊疗水平。方法:回顾性分析我院曾收治的23例肠道结外鼻型NK/T细胞淋巴瘤患者的临床资料,从性别、年龄、临床症状、镜下表现、实验室检查、病理特征、治疗手段、预后情况等多方面进行分析总结。结果:男女比例2.83∶1,中位年龄45岁,中位生存期60天(95%CI:44.4~75.6),1年生存率26.1%。常见症状有发热、腹痛、腹泻、便血等,最常见部位为大肠(56.5%),其次为小肠(26.1%)、小肠+大肠(17.4%)。内镜下肠道病变以弥漫不规则多发溃疡为主(65.2%),其次为局限性溃疡(17.4%)、黏膜病变(13.0%)、息肉样隆起(4.3%),首次肠镜+活检确诊率17.4%。其常见并发症为穿孔、大出血。EBER阳性(P=0.003)、急诊手术(P=0.001)是肠道NKTCL预后不良的预测因素。结论:肠道NK/T细胞淋巴瘤发病以中青年男性为主,临床表现无特异性,易误诊。免疫组化在诊断及鉴别诊断上具有重要意义。诊断困难,预后差,穿孔或大出血前进行手术治疗可能会改善预后。临床中遇到腹痛、腹泻、便血并伴有B症状、LDH升高、EBV阳性且病情进展快的患者,应警惕NK/T细胞淋巴瘤的可能。
Objective: To analyze the clinical features of patients with intestinal extranodal nasal type NK / T cell lymphoma in order to improve the understanding of the disease and diagnosis and treatment. Methods: The clinical data of 23 patients with extranodal nasal type NK / T cell lymphoma who had been treated in our hospital were retrospectively analyzed. The clinical data of patients with NK / T cell lymphoma were retrospectively analyzed. The clinical data were analyzed retrospectively from gender, age, clinical symptoms, microscopic findings, laboratory tests, , Prognosis and many other aspects of analysis and summary. Results: The male-female ratio was 2.83:1, the median age was 45 years. The median survival time was 60 days (95% CI: 44.4-75.6). The 1-year survival rate was 26.1%. Common symptoms are fever, abdominal pain, diarrhea, blood in the stool, the most common sites for the large intestine (56.5%), followed by the small intestine (26.1%), small intestine + large intestine (17.4%). Endoscopic lesions mainly diffuse irregular ulcers (65.2%), followed by localized ulcers (17.4%), mucosal lesions (13.0%), polyposis-like protuberances (4.3%), primary colonoscopy + biopsy Rate of 17.4%. The common complications of perforation, bleeding. EBER was positive (P = 0.003), and emergency surgery (P = 0.001) was a predictor of poor prognosis of intestinal NKTCL. Conclusion: The incidence of intestinal NK / T cell lymphoma is mainly in middle-aged and young men. The clinical manifestations are nonspecific and easily misdiagnosed. Immunohistochemistry in the diagnosis and differential diagnosis of great significance. Diagnosis is difficult, the prognosis is poor, perforation or bleeding before surgical treatment may improve the prognosis. Clinical encounter abdominal pain, diarrhea, blood in the stool and accompanied by symptoms of B, elevated LDH, EBV positive and rapid progression of patients, should be alert to the possibility of NK / T cell lymphoma.