Objective: To investigate the clinical manifestations, endoscopic characteristics, and prognostic factors of patients with colorectal extranodal NK/T cell lymphoma. Methods: The clinical data of 52 patients with colorectal extranodal NK/T cell lymphoma admitted to the First Affiliated Hospital of Zhengzhou University from January 2013 to January 2023 were retrospectively analyzed. Their clinical manifestations and endoscopic characteristics were summarized, and the prognostic factors were analyzed by Cox regression model. Results: Among the 52 patients with colorectal extranodal NK/T cell lymphoma, there were 35 males and 17 females, with a male-to-female ratio of 2.06∶1. Among the general symptoms, abdominal pain was the most common (39 cases), and B symptoms occurred in 47 patients, among which fever was the most common lymphoma B symptom (42 cases), and gastrointestinal perforation was the most common complication (18 cases). Forty-three patients underwent colonoscopy, and the main manifestations under endoscopy were the ulceration type (24 cases). The ulcers were irregular at the edges and often covered with moss at the bottom. The median survival time was 4.3 months. Multivariate Cox regression analysis showed that hemocytic syndrome (HR=8.50,95% CI: 1.679-8.328,P=0.001), serum albumin (HR=3.59,95% CI: 1.017-6.551, P=0.048), and with or without chemotherapy (HR=0.31, 95% CI: 0.246-1.061, P=0.025) were independent factors influencing the overall survival of patients with colorectal extranodal NK/T cell lymphoma. Conclusions: Colorectal extranodal NK/T cell lymphoma is a rare disease with a very poor prognosis. When patients present with abdominal pain and lymphoma B symptoms, and when ulcers with irregular edges and moss covering the bottom are found under endoscopy, the disease should be considered, and endoscopic biopsy should be taken in time for pathological diagnosis. The prognosis of patients with hemophagocytic syndrome and hypoproteinemia is poor. This disease should be treated with chemotherapy and surgery, and on this basis, hemophagocytic syndrome and hypoproteinemia should be treated to improve the prognosis of patients.
目的： 探讨结直肠结外NK/T细胞淋巴瘤患者的临床表现、内镜下特点及预后影响因素。 方法： 对2013年1月至2023年1月郑州大学第一附属医院收治的52例结直肠结外NK/T细胞淋巴瘤患者的临床资料进行回顾性分析，归纳其临床表现及内镜下特点，并采用Cox回归模型进行预后影响因素分析。 结果： 52例结直肠结外结外NK/T细胞淋巴瘤患者中，男35例，女17例，男女之比为2.06∶1。临床症状中腹痛最常见（39例）。47例患者出现B症状，其中发热为最常见的B症状（42例）。消化道穿孔为最常见的并发症（18例）。43例行结肠镜检查，内镜下表现以溃疡型为主（24例），可见溃疡边缘不规则，底部常覆污苔。全组患者的中位生存时间为4.3个月。多因素Cox回归分析显示，嗜血细胞综合征（HR=8.50，95% CI：1.679～8.328，P=0.001）、血清白蛋白（HR=3.59，95% CI：1.017～6.551，P=0.048）及是否化疗（HR=0.31，95% CI：0.246～1.061，P=0.025）是结直肠结外NK/T细胞淋巴瘤患者总生存的独立影响因素。 结论： 结直肠结外NK/T细胞淋巴瘤是一种罕见且预后极差的疾病，如患者出现腹痛及淋巴瘤B症状，且内镜下发现边缘不规则、底部覆污苔的溃疡时应考虑该病，并及时内镜下取活检行病理诊断。合并嗜血细胞综合征和低蛋白血症的患者预后较差，应积极采取化疗、手术等手段治疗结外NK/T细胞淋巴瘤这一原发疾病，在此基础上对嗜血细胞综合征和低蛋白血症进行治疗以改善患者的预后。.