■结外非霍奇金淋巴瘤(NHL)在胃肠道(GI)中比在其他部位更为普遍。本研究旨在探讨原发性肠道弥漫性大B细胞淋巴瘤(PI-DLBCL)的临床特征及预后因素,以期为罕见结外恶性淋巴瘤的基础研究和临床诊治提供新的参考依据。
■回顾性分析2011年6月至2022年6月福建医科大学附属协和医院收治的88例PI-DLBCL患者的临床资料,临床和病理特征,分析PI-DLBCL的诊治过程及预后,并对预后因素进行单因素和多因素分析。采用Kaplan-Meier法进行生存分析。同时,检索PubMed的最新文献,系统讨论PI-DLBCL的诊断和治疗研究进展。
■本研究纳入的88例PI-DLBCL患者中,男性60例(68.18%),28例女性(31.82%),62例患者(70.45%)主诉腹痛,其次最常见的临床表现是16例(18.18%)的排便习惯改变,发病年龄中位数为57岁(17-82岁)。一线治疗方案为手术联合R-CHOP化疗(56.82%)。中位随访时间72(1-148)个月,88例PI-DLBCL患者中有51例(57.95%)存活,30例患者(34.09%)死亡,7例(7.95%)患者失访,和1年的PFS率,3年和5年为57.95%,29.55%和15.91%,和1年的OS率,3年和5年为79.55%,45.45%和28.41%,分别。单因素Cox回归分析结果显示,ECOG评分,卢加诺舞台,B症状,IPI得分,白细胞,血清LDH,白蛋白,β2微球蛋白是PI-DLBCL患者OS的影响因素,和ECOG得分,卢加诺舞台,B症状,IPI得分,白细胞,血清LDH,白蛋白,β2微球蛋白均为PI-DLBCL患者PFS的影响因素。多因素Cox分析结果显示,Lugano分期可能是影响PI-DLBCL患者OS和PFS的独立预后因素。
■PI-DLBCL多见于中老年男性,临床表现缺乏特异性,一线治疗主要是手术联合标准化疗方案。Lugano分期可能是影响PI-DLBCL患者OS和PFS的独立预后因素。
UNASSIGNED: Extranodal Non-Hodgkin lymphoma (NHL) is more prevalent in the gastrointestinal (GI) tract than in other sites. This study aimed to explore the clinical features and prognostic factors of primary intestinal diffuse large B-cell lymphoma (PI-DLBCL), in order to provide new references for basic research and clinical diagnosis and treatment of the rare extranodal malignant lymphoma.
UNASSIGNED: The clinical data of 88 patients with PI-DLBCL admitted to Fujian Medical University Union Hospital from June 2011 to June 2022 were retrospectively studied, the clinical and pathological features, diagnosis and treatment process and prognosis of PI-DLBCL were analyzed, and univariate and multivariate analysis of prognostic factors was carried out. The Kaplan-Meier method was used for survival analysis. Meanwhile, the latest literature from PubMed was retrieved to systematically discuss the research progress in the diagnosis and treatment of PI-DLBCL.
UNASSIGNED: Among the 88 patients with PI-DLBCL included in this study, 60 cases were males (68.18%), 28 cases were females (31.82%), and 62 patients (70.45%) were complaining of abdominal pain, and the second most common clinical manifestation was changes in bowel habits in 16 (18.18%), with a median age of onset of 57 (17-82) years. The first-line treatment regimen was surgery combined with R-CHOP chemotherapy (56.82%). The median follow-up time was 72 (1-148) months, 51 (57.95%) of 88 patients with PI-DLBCL survived, 30 patients (34.09%) died, 7 patients (7.95%) were lost to follow-up, and the PFS rates of 1-year, 3-year and 5-year were 57.95%, 29.55% and 15.91%, and the OS rates of 1-year, 3-year and 5-year were 79.55%, 45.45% and 28.41%, respectively. The results of univariate Cox regression analysis showed that ECOG score, Lugano stage, B symptoms, IPI score, white blood cells, serum LDH, albumin, β2 microglobulin were the influencing factors of OS in PI-DLBCL patients, and ECOG score, Lugano stage, B symptoms, IPI score, white blood cells, serum LDH, albumin, β2 microglobulin were all the influencing factors of PFS in PI-DLBCL patients. The results of multivariate Cox analysis showed that Lugano stage may be an independent prognostic factor affecting OS and PFS in PI-DLBCL patients.
UNASSIGNED: PI-DLBCL is more common in middle-aged and elderly men, clinical manifestations lack specificity, first-line treatment is mainly surgery combined with standard chemotherapy regimens. The Lugano stage may be an independent prognostic factor affecting OS and PFS in PI-DLBCL patients.