摘要目的 探讨肠道原发性非霍奇金淋巴瘤(PINHL)的临床病理学特征及预后因素.方法 收集确诊的273例PINHL患者资料,分析临床病理学特点、诊断情况及预后影响因素.结果 273例患者中男女比例为2.3∶1,中位发病年龄为46(2～85)岁,B细胞淋巴瘤组以腹部包块多见,而T细胞淋巴瘤组以穿孔、下腹疼痛及B症状更为常见.病变部位以回盲部最多见(30.4％).肠镜活检确诊率为90.3％.病理学分型:B细胞淋巴瘤232例(85.0％),以弥漫大B细胞淋巴瘤,非特指型(DLBCL,NOS)最为多见(48.4％);T细胞淋巴瘤41例(15.0％),以肠病相关性T细胞淋巴瘤最为多见(36.6％).获得完整随访资料者245例,B细胞淋巴瘤组患者预后明显好于T细胞淋巴瘤组(P＜0.05),手术对于患者整体生存率无明显影响,但对于侵袭性淋巴瘤患者可以提高其生存率.结论 国人PINHL以B细胞淋巴瘤多发,T、B细胞淋巴瘤患者具有不同的临床特点.肠镜活检是较好的确诊方法.B细胞淋巴瘤患者预后明显好于T细胞淋巴瘤,侵袭性淋巴瘤患者可能从手术中获益.

abstractsObjective To study the clinicopathological characteristics and prognostic factors in Chinese patients with primary intestinal non-Hodgkin' s lymphomas (PINHL).Methods The clinical symptoms,pathological features,diagnostic and prognostic factors of 273 cases diagnosed with PINHL from our center were analyzed.Results Among 273 cases,189 were male and 84 female,the male to female ratio was 2.3 ∶ 1.The age of patients ranged from 2 to 85 years old with the median age of 46.The most frequent site of the lesions was ileocecus (n=83,30.4％).The clinical symptoms of PINHL were unspecific with abdominal mass frequently seen in B-cell lymphoma,and perforation,hypogastric pain and "B" symptoms more common in T-cell lymphoma.Endoscopic biopsy diagnosis rate was 90.3％.Of 273 cases,B-cell lymphoma (n=232,85.0％) dominated PINHL with the most common subtype of diffuse large B-cell lymphoma-not otherwise specified (DLBCL-NOS) (n=132,48.4％),while the T-cell lymphoma (n=41,15.0％) were much less seen with the most common subtype of enteropathy-associated T-cell lymphoma (EATL) (n=15,36.6％).There were 245 cases were followed up,including 206 cases of B-cell lymphoma and 39 cases of T-cell lymphoma,it was found that the prognosis of B-cell lymphoma is much better than that of T-cell lymphoma (P＜0.05).Operation had no significant effect for the overall survival rate.But for patients with aggressive lymphoma,operation can improve the survival rate.Conclusions It indicates that PINHL often occurs as B cell type,DLBCL-NOS is the most common histological type.Ileocecus is the most common site involved and enteroscope biopsy is a good method of diagnosis.Compared with T-cell lymphoma,B-cell lymphoma has different clinical manifestations and a better prognosis.Patients with aggressive lymphoma can benefit from operation.