Objective: To explore and analyze the clinical features and prognostic factors of secondary intestinal diffuse large B-cell lymphoma (SI-DLBCL), in order to provide reference for the basic research and clinical diagnosis and treatment of secondary lymphoma of rare sites in the field of hematology.
Methods: The clinical data of 138 patients with SI-DLBCL admitted to Fujian Medical University Union Hospital from June 2011 to June 2022 were collected and sorted, the clinical and pathological features, diagnosis, treatment and prognosis were analyzed. Cox regression risk model was used to conduct univariate and multivariate analysis on the prognostic risk factors.
Results: Among the 138 patients with SI-DLBCL included in this study, 85 (61.59%) were male, 53 (38.41%) were female, the median age of onset was 59.5 (16-84) years, the clinical manifestations lacked specificity, the first-line treatment regimen was mainly chemotherapy (67.39%), 94 cases (68.12%) received chemotherapy alone, 40 cases (28.98%) were treated with chemotherapy combined with surgery, and 4 cases (2.90%) were treated with surgery alone. The median follow-up time was 72 (1-148) months. Among the 138 patients with SI-DLBCL, 79 (57.25%) survived, 34 (24.64%) died, 25 cases (18.12%) lost to follow-up, the PFS rates of 1-year, 3-year and 5-year were 57.97%, 49.28% and 32.61%, and the OS rates of 1-year, 3-year and 5-year were 60.14%, 54.35% and 34.06%, respectively. The results of univariate Cox regression analysis showed that age, Lugano stage and IPI score were the influencing factors of OS in SI-DLBCL patients, and age, Lugano stage and IPI score were the influencing factors of PFS in SI-DLBCL patients. The results of multivariate Cox analysis showed that Lugano stage was an independent prognostic factor affecting OS and PFS in SI-DLBCL patients.
Conclusion: Patients with SI-DLBCL are more common in middle-aged and elderly men, and the early clinical manifestations lack specificity, and the first-line treatment regimen is mainly R-CHOP chemotherapy, and Lugano stage is an independent prognostic factor affecting OS and PFS in SI-DLBCL patients.
题目: 继发性肠道弥漫大B细胞淋巴瘤的临床特征及预后分析.
目的: 探讨和分析继发性肠道弥漫大B细胞淋巴瘤（SI-DLBCL）的临床特征及预后因素，以期为血液病学领域中罕见部位继发性淋巴瘤的基础研究与临床诊疗提供借鉴与参考。.
方法: 收集并整理福建医科大学附属协和医院2011年6月-2022年6月收治的138例SI-DLBCL患者的临床资料，分析其临床和病理特征、诊治经过及预后情况，并采用Cox回归风险模型对其预后风险因素进行单因素和多因素分析。.
结果: 本研究纳入的138例SI-DLBCL患者中，男性85例（61.59%），女性53例（38.41%），中位发病年龄59.5（16-84）岁，临床表现缺乏特异性，一线治疗方案以化疗（67.39%）为主，单纯接受化疗94例（68.12%），化疗联合外科治疗40例（28.98%），单纯外科治疗4例（2.90%）。中位随访时间72（1-148）个月，其中存活79例（57.25%），死亡34例（24.64%），失访25例（18.12%），1、3、5年PFS率分别为57.97%、49.28%和32.61%，1、3、5年OS率分别为60.14%、54.35%和34.06%。单因素Cox回归分析结果显示，年龄、Lugano分期、IPI评分是SI-DLBCL患者OS、PFS的影响因素。多因素Cox回归分析结果显示，Lugano分期是影响SI-DLBCL患者OS及PFS的独立预后因素。.
结论: SI-DLBCL患者以中老年男性多见，早期临床表现缺乏特异性，一线治疗方案以R-CHOP方案化疗为主，Lugano分期是影响SI-DLBCL患者OS及PFS的独立预后因素。.
Keywords: secondary diffuse large B-cell lymphoma; intestine; digestive system; prognosis.