原发性大肠淋巴瘤内镜和病理的相关性及预后影响因素分析

Correlation and prognostic influence factors' analysis #br# of endoscopic presentation and pathological of #br# primary colon lymphoma

摘要:

目的  探讨大肠淋巴瘤的临床、内镜、病理特点及影响预后的相关因素，以提高大肠淋巴瘤的诊治水平。方法  回顾性分析5年来该院经手术和内镜活检病理证实的20例大肠淋巴瘤的临床表现及内镜特点。 结果  男女比例为1.22∶1，中位年龄58岁（29～90岁），13例患者以腹痛为主诉就诊，9例病变位于回盲部，11例内镜下表现为溃疡，4例内镜下表现为息肉，2例表现为累及全结肠的弥漫充血性红斑，肿瘤直径1～12 cm不等，11例病理类型为弥漫大B细胞淋巴瘤，10例患者Ki-67超过60.0%。8例乳酸脱氢酶（LDH）水平高于正常。结论  原发性大肠淋巴瘤男性略多于女性，好发于回盲部，内镜下溃疡型多见，弥漫性大B细胞淋巴瘤是最常见的病理类型。乳酸脱氢酶和肿瘤大小与预后相关。

Abstract:

 【Objective】 To improve the diagnostic level of the large intestine lymphoma and discuss related factors affecting prognosis of this disease, clinical presentation, endoscopic and pathological characteristics of large intestine lymphoma were discussed. 【Methods】 Clinical presentation and endoscopic features of twenty cases of large intestine lymphoma verified by surgery and endoscopic biopsy pathology over the past 5 years in our hospital were analyzed retrospectively. 【Results】 The rate of male to female was 1.22∶1 and the median age 58 (29～90). Abdominal pain was the chief complaint of thirteen cases. Nine cases had lesion locations in ileocecal region. Under endoscopic examination, eleven cases presented with ulcer type neoplasm whose diameters were around 1～12 cm. The pathologic type of eleven cases was diffuse large B cell lymphoma and Ki-67 of ten cases was more than 60.0%. The LDH level was higher than normal in eight cases. 【Conclusion】 Male was slightly more than female in primary large intestine lymphoma. Ileocecal region was the most frequent lesion location. Ulcer type was the most frequent endoscopic presentation and diffuse large B cell lymphoma was the most pathologic type. LDH and tumor size were key factors affecting prognosis of large intestine lymphoma.