Bowel perforation in intestinal lymphoma: incidence and clinical features
Bowel perforation in intestinal lymphoma: incidence and clinical features
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DOI：
10.1093/annonc/mdt188
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发表时间：
2013-09-01
影响因子：
50.5
通讯作者：
Witzig, T. E.
中科院分区：
文献类型：
--
作者：
Vaidya, R.;Habermann, T. M.;Witzig, T. E.
穿孔是一种严重的危及生命的并发症淋巴瘤涉及胃肠道（GI）道。虽然有些穿孔发生在胃肠道淋巴瘤的最初表现，其他发生在化疗开始后。为了确定穿孔的位置和时间，对所有GI淋巴瘤患者进行了一项单中心研究。在1975年至2012年期间，确定了1062例经活检证实的淋巴瘤累及GI的患者。通过回顾性病历分析来识别肠穿孔患者并确定其临床病理特征，9%（92/1062）的患者发生穿孔，其中55%（51/92）发生在化疗后。开始化疗后穿孔的中位天数为46天（平均83天;范围2-298天），44%的穿孔发生在治疗的前4周内。弥漫性大B细胞淋巴瘤（DLBCL）是最常见的淋巴瘤与穿孔（59%，55/92）。与惰性B细胞淋巴瘤相比，侵袭性B细胞淋巴瘤（HR = 6.31，P < 0.0001）或T细胞/其他类型（HR = 12.40，P < 0.0001）穿孔的风险更高。小肠是最常见的穿孔部位（59%），穿孔仍然是胃肠道淋巴瘤的一个重要并发症，并且与侵袭性淋巴瘤比惰性淋巴瘤更常见。由爱荷华州大学/马约诊所SPORE CA 97274和Predolin基金会提供部分支持。
Perforation is a serious life-threatening complication of lymphomas involving the gastrointestinal (GI) tract. Although some perforations occur as the initial presentation of GI lymphoma, others occur after initiation of chemotherapy. To define the location and timing of perforation, a single-center study was carried out of all patients with GI lymphoma.Between 1975 and 2012, 1062 patients were identified with biopsy-proven GI involvement with lymphoma. A retrospective chart review was undertaken to identify patients with gut perforation and to determine their clinicopathologic features.Nine percent (92 of 1062) of patients developed a perforation, of which 55% (51 of 92) occurred after chemotherapy. The median day of perforation after initiation of chemotherapy was 46 days (mean, 83 days; range, 2-298) and 44% of perforations occurred within the first 4 weeks of treatment. Diffuse large B-cell lymphoma (DLBCL) was the most common lymphoma associated with perforation (59%, 55 of 92). Compared with indolent B-cell lymphomas, the risk of perforation was higher with aggressive B-cell lymphomas (hazard ratio, HR = 6.31, P < 0.0001) or T-cell/other types (HR = 12.40, P < 0.0001). The small intestine was the most common site of perforation (59%).Perforation remains a significant complication of GI lymphomas and is more frequently associated with aggressive than indolent lymphomas. Supported in part by University of Iowa/Mayo Clinic SPORE CA97274 and the Predolin Foundation.