Primary gastrointestinal non-Hodgkin's lymphoma in adults: a population-based clinical and histopathologic study
Primary gastrointestinal non-Hodgkin's lymphoma in adults: a population-based clinical and histopathologic study
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DOI：
10.1046/j.1365-2796.1998.00317.x
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发表时间：
1998-07-01
影响因子：
11.1
通讯作者：
Ralfkiaer, E
中科院分区：
文献类型：
--
作者：
Hansen, PB;Vogt, KC;Ralfkiaer, E
目标。分析成人原发性胃肠道非霍奇金淋巴瘤 (GI-NHL) 的临床病程和组织病理学，并研究幽门螺杆菌的可能影响。设计/设置。对哥本哈根县 6 年来诊断出的 NHL 成年患者进行的回顾性研究。受试者。 1985年至1990年底期间共诊断出55例GI-NHL患者。结果。 28 例患者原发性淋巴瘤位于胃，14 例位于小肠，11 例位于大肠，2 例患者有多灶性受累；主要症状是腹痛、体重减轻、腹泻、便秘和疲劳。初次就诊时出现严重出血或穿孔等急性紧急问题并不常见。根据修订后的欧美淋巴瘤 (REAL) 分类，弥漫性大 B 细胞淋巴瘤是最常见的组织学亚型，占病例的 53%。 在 25 名可评估的胃淋巴瘤患者中，有 15 名 (60%) 记录有幽门螺杆菌感染，且与任何特定的组织学亚型无关。内窥镜检查和钡 X 射线是灵敏度最高的诊断方法。总共有 30 名患者（58%）获得完全缓解，10 名患者（19%）获得部分缓解，12 名患者（23%）对治疗没有反应。总体5年生存率为0.36，组织学亚型之间没有统计学显着差异。同样，幽门螺杆菌的存在也不影响生存。结论。原发性胃肠道非霍奇金淋巴瘤是一种异质性疾病，其治疗方法存在很大争议。没有特定的临床或组织学表型与幽门螺杆菌的存在相关。
Objectives. To analyse the clinical course and the histopathology of primary gastrointestinal non-Hodgkin's lymphoma (GI-NHL) in adult patients and to investigate a possible impact of Helicobacter pylori.Design/setting. Retrospective study of all adult patients in Copenhagen county diagnosed during a 6-year period with NHL.Subjects. A total of 55 patients with GI-NHL diagnosed during the period from 1985 to the end of 1990.Results. Twenty-eight patients had primary lymphoma in the stomach, 14 in the small intestine, 11 in the large intestine and two patients had multifocal involvement; The dominant presenting symptoms were abdominal pain, weight loss, diarrhoea, constipation and fatigue. Acute emergency problems such as severe haemorrhage or perforation at initial presentation were unusual. According to the revised European-American lymphoma (REAL) classification, diffuse large B-cell lymphoma was the most frequent histologic subtype comprising 53% of the cases.Helicobacter pylori infection was documented in 15 of 25 evaluable patients (60%) with gastric lymphomas and was not associated with any specific histological subtype. Endoscopic procedures and barium X-rays were the diagnostic approaches with highest sensitivity. In total, 30 patients (58%) achieved complete remission, 10 (19%) achieved partial remission, and 12 (23%) did not respond to treatment. The overall 5 year survival rate was 0.36 without statistically significant difference between the histological subtypes. Likewise the presence of Helicobacter pylori did not affect survival.Conclusion. Primary GI-NHL is a heterogeneous disease entity with considerable therapeutic controversies. No specific clinical or histological phenotype was associated with the presence of Helicobacter pylori.