Diagnosis And Treatment Analysis For Primary Small Intestine Lymphoma Of59Cases

AIM:To summarize the clinical characteristics of primary small intestinal lymphoma (PSIL), evaluate the diagnostic values of various imaging or endoscope examinations for PSIL, analyze the correlation between the general condition, clinical characteristics, pathologic features, treatment of these patients and its prognostic factors.METHODS:The clinical data of59PSIL patients diagnosed in The First Affiliated Hospital of Medical School of Zhejiang University in the last8years (2007.01-2015.06) were analyzed retrospectively. And the follow-up findings were adopted for comprehensive analysis. RESULTS:In59cases o PSIL,53cases were followed-up for a mean time of25months(range:l-106months),39patients were male and20were female, the sex ratio was2.0:1, the range of ages was from18to81years old, median age was58years old,48patients were treated with surgical resection,11with others.44cases(75%) were diagnosed as B cell lymphoma;15cases(25%) were of multiple sites, of the rest44cases, the ileum,(24/59,41%) was the most common involved site, followed by jejunum(l5/59,25%), duodenum(4/59,7%). Obstruction (30/59,51%), gastrointestinal bleeding (27/59,46%), and intestinal perforation (17/59,29%) were common complications. The detection rate of spiral CT was96%. And the follow-up analysis of one year overall survival rate was collected (in univariate analysis):the mortality of patients with T-cell lymphoma was longer than the one of patients with B-cell lymphoma (7%vs76%, X2=27.7, P<0.05), The prognosis of patients with fever during the treatment was worse (41%vs70%,%2=7.0, P<0.05), and the same result as patients with tumor perforation (29%vs71%, x2=10.2, P<0.05). In multivariate analysis, only B-cell lymphoma were assosiated with better survival(HR28.526,95%CI3.006-270.671, P＜0.05).CONCLUSION:PSIL has no specific clinical manifestations, diagnosis should be combined with a variety of means, operation combined with chemotherapy is important for PSIL. Histological classification, perforation, treatment may help to predict the prognosis of PSIL.