USEFULNESS OF DOUBLE BALLOON ENTEROSCOPY AND VIDEO CAPSULE ENDOSCOPY FOR THE DIAGNOSIS AND MANAGEMENT OF PRIMARY FOLLICULAR LYMPHOMA OF THE GASTROINTESTINAL TRACT IN ITS EARLY STAGES
USEFULNESS OF DOUBLE BALLOON ENTEROSCOPY AND VIDEO CAPSULE ENDOSCOPY FOR THE DIAGNOSIS AND MANAGEMENT OF PRIMARY FOLLICULAR LYMPHOMA OF THE GASTROINTESTINAL TRACT IN ITS EARLY STAGES
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DOI：
10.1111/j.1443-1661.2009.00915.x
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发表时间：
2010-01-01
影响因子：
5.3
通讯作者：
Tanaka, Eiji
中科院分区：
文献类型：
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作者：
Akamatsu, Taiji;Kaneko, Yasunori;Tanaka, Eiji
目的：本研究的目的是评估双球囊内镜（DBE）和视频胶囊内镜（VCE）在胃肠道原发性滤泡性淋巴瘤（FL）患者中的应用价值。此外，我们评估了包括利妥昔单抗在内的化疗（环磷酰胺、阿霉素、长春新碱和强的松）对他们的有效性。方法：对2005年7月至2008年9月连续13例诊断为十二指肠滤泡菌的患者进行分析。所有患者均接受常规分期检查，包括采用DBE和/或VCE手术的全肠镜检查。经书面知情同意后进行化疗。每6-12个月进行一次疗效评估。中位随访时间为30.2个月。结果：每个患者的FL诊断为低级别（1级，n = 7； 2级，n = 6），除4例患者外，所有患者均诊断为局限性淋巴瘤（I期，n = 8； II1期，n = 1； II2期，n = 4）。DBE显示10例患者空肠多灶性病变，6例患者回肠多灶性病变。最近2例VCE在空肠也有类似的表现。13例患者中有11例最终接受了化疗，均达到完全消退。在那之后，他们没有出现复发的迹象。结论：治疗前应采用DBE对小肠进行全面检查，以选择合适的治疗方法。另一方面，VCE对于筛查和跟踪患者的小肠是有用的。化疗是实现胃肠道原发FL完全消退的有效方法。
Aim:The aim of this study is to evaluate the usefulness of double balloon enteroscopy (DBE) and video capsule endoscopy (VCE) in patients with primary follicular lymphoma (FL) of the gastrointestinal (GI) tract. Furthermore, we estimate the effectiveness of chemotherapy (cyclophosphamide, doxorubicin, vincristine, and prednisone) including rituximab for them.Methods:Thirteen consecutive patients who were diagnosed of having FL in the duodenum between July 2005 and September 2008 were studied. All patients were given the conventional staging examinations, including total enteroscopy using DBE and/or VCE procedures. Chemotherapy was performed after written informed consent. Response assessment was performed every 6-12 months. The median follow-up period was 30.2 months.Results:FL was diagnosed in each patient as low grade (grade 1, n = 7; 2, n = 6) and, in all but 4 patients, localized lymphoma (stage I, n = 8; II1, n = 1; II2, n = 4). DBE revealed multifocal lesions in the jejunum in 10 of the patients, and in the ileum in 6. VCE showed similar findings in the jejunum in the recent 2 patients. Eleven of 13 patients finally received chemotherapy, and all of them achieved complete regression. They showed no evidence of recurrence after that.Conclusion:Total examination of the small intestine using DBE should be performed before treatment to choose a suitable treatment procedure for primary FL of the GI tract. On the other hand, VCE is useful for screening and following the small intestine in the patients with it. Chemotherapy is effective to achieve complete regression of primary FL of the GI tract.