|Table of Contents|

Clinical features and prognosis of intestinal extranodal NK/T cell lymphoma，nasal type

Journal Of Modern Oncology[ISSN:1672-4992/CN:61-1415/R]

Issue:
2017 01
Page:
86-90
Research Field:
Publishing date:

Info

Title:
Clinical features and prognosis of intestinal extranodal NK/T cell lymphoma，nasal type
Author(s):
Li Yani; Wang Xiaojuan; Liang Shuhui; Liu Zhenzhen; Zhang Yujie; Wang Biaoluo; Shi Yongquan; Wu Kaichun
Xijing Hospital of Digestive Diseases，Fourth Military Medical University，Shaanxi Xi'an 710032，China.
Keywords:
intestinal NK/T cell lymphoma; epstein-barr virus; irregular ulcers; immunohistochemistry; prognosis
PACS:
R730.263
DOI:
10.3969/j.issn.1672-4992.2017.01.024
Abstract:
Objective：To analyze clinical features of intestinal extranodal NK/T cell lymphoma，nasal type，to improve the understanding of the disease and the diagnosis and treatment level.Methods：The clinical data of 23 intestinal extranodal NK/T cell lymphoma patients treated in our hospital were retrospectively analyzed for their gender，age，clinical manifestations，endoscopic findings，laboratory examination，pathological features，therapeutic approach and prognosis.Results：The male∶female ratio was 2.83∶1，The median age was 45 years old and the median survival period was 60 days (95% confidence interval:44.4~75.6）.1-year overall survival rate was 26.1%.The common symptoms consisted of fever，abdominal pain，diarrhea，and hematochezia.The most common site of involvement was the colorectum (56.5%)，followed by the small intestinal (26.1%)，both small and large intestinal (17.4%）.Endoscopically，the lesion types were mainly featured by multifocal or diffuse irregular ulcers (65.2%)，followed by local ulcers (17.4%)，mucosal lesion (13.0%)，tumorous lesion (4.3%)，initial accurate diagnosis rate was 17.4% endoscopically.The common complication are intestinal perforation and intestinal massive hemorrhage.The negative prognostic factors for survival were the positive EBER (P=0.003） and emergency operation (P=0.001).Conclusion：Intestinal NK/T cell lymphoma most frequently favor young men，clinical manifestations has not specificity.Immunohistochemistry play a key role in differential diagnosis，its diagnosis is difficult，with a poor prognosis.Surgery before perforation or hemorrhage may improve prognosis.We should be alert to the possibility of NK/T cell lymphoma，when we encounter the patients who have abdominal pain，diarrhea，hematochezia and B syndrome，elevated LDH，positive-EBV.

References:

［1］Lymphoma Study Group of Japanese Pathologists.The World Health Organization classification of malignant lymphomas in Japan：Incidence of recently recognized entities［J］.Pathol Int，2000，50：696-702.
［2］Li B，Shi YK，He XH，et al.Primary non-Hodgkin lymphomas in the small and large intestine：clinicopathological characteristics and management of 40 patients［J］.Int J Hematol，2008，87(4)：375-381.
［3］Ran W，Ouyang Q.Primary intestinal non-Hodgkin's lymphoma：a retrospective study of 85 cases［J］.J South Med Univ，2012，32(4)：534-538.
［4］Fang Y，Yang JM，Song XM，et al.Clinical analysis of extranodal NK/T cell lymphoma，nasal type［J］.Chin J Clinicians，2010，4(5)：583-590．
［方圆，杨建民，宋献民，等．结外鼻型ＮＫ／Ｔ细胞淋巴瘤临床分析［J］.中华临床医师杂志，2010，4(5)：583-590．］
［5］Carbone PP，Kaplan HS，Musshoff K，et al.Report of the committee on Hodgkin's disease staging classification［J］.Cancer Res，1971，31(11)：1860-1861.
［6］Stanojevic GZ，Nestorovic MD，Brankovic BR，et al.Primary colorectal lymphoma：an overview［J］.World J Gastrointest Oncol，2011，3(1)：14-18.
［7］Zheng S，Ouyang Q，Li G，et al.Primary intestinal NK/T cell lymphoma：a clinicopathologic study of 25 Chinese cases［J］.ArchIran Med，2012，15(1)：36-42.
［8］Jiang M，Chen X，Yi Z，et al.Prognostic characteristics of gastrointestinal tract NK/T-cell lymphoma：An analysis of 47 patients in china［J］.J Clin Gastroenterol，2013，47(8)：e74-79.
［9］Sun J，Yang Q，Lu Z，et al．Distribution of lymphoid neoplasms in china：analysis of 4638 cases according to the World Health Organization classification［J］.Am J Clin Pathol，2012，138(3）：429．
［10］Kim JH，Lee JH，Lee J，et al．Primary NK-/T-cell lymphoma of the gastrointestinal tract：clinical characteristics and endoscopic finding［J］.Endoscopy，2007，39(2）：156．
［11］Nakamura S，Matsumoto T，Iida M，et al.Primary gastrointestinal lymphoma in Japan：a clinicopathologic analysis of 455 patiets with special reference to its time trends［J］.Cancer，2003，97：2462-2473.
［12］Papaxoinis G，Papageorgiou S，Rontogianni D，et al.Primary gastroin testinal non-Hodgkin' s lymphoma：a clinicopathologic study of 128 cases in Greece.A Hellenic Cooperative Oncology Group study(HeCOG)［J］.Leuklymphoma，2006，47(12）：2140-2146.
［13］Kim do H，Lee D，Kim JW.Endoscopic and clinical analysis of primary T-cell lymphoma of the gastrointestinal tract according to pathological subtype［J］.J Gastroenterol Hepatol，2014，29(5)：934-943.
［14］Kim YH，Lee JH，Yang SK，et al．Primary colon lymphoma in Korea：a KASID (Korean Association for the Study of Intestinal Diseases） study［J］．Dig Dis Sci，2005，50(12）：2243．
［15］Xu W，Zhou C，Zhan G，et al．Repeating gastric biopsy for accuracy of gastric lymphoma diagnosis［J］．Gastroenterol Nurs，2010，33：313-317．
［16］Al-Hakeem DA，Fedele S，Carlos R，et al.Extranodal NK/T-cell lymphoma，nasal type［J］.Oral Oncology，2007，43(1)：4-14.
［17］Wen JY，Li M，Li X，et al.Efficacy and tolerance of pegaspargase-based chemotherapy in patients with nasal-type extranodal NK/T-cell lymphoma：a pilot study［J］.Asian Pac J Cancer Prev，2014，15(15)：6275-6281.
［18］Zhang XY，Wang XM，Mu Hetabaier，et al.24 cases of primary gastrointestinal lymphoma［J］.J Leukemia & Lymphoma，2009，18（9）：562-563.［张晓燕，王晓敏，木合塔拜尔，等．原发胃肠道淋巴瘤24例［J］.白血病·淋巴瘤，2009，18（9）：562-563.］
［19］Ko YH，Cho EY，Kim JE，et al.NK and NK-like T-cell lymphoma in extranasal sites：A comparative clinicopathological study according to site and EBV status［J］.Histopathology，2004，44：480-489.
［20］Cohen JI，Kimura H，Nakamura S，et al.Epstein-Barr virus-associated lymphoproliferative disease in non-immunocompromised hosts：a status report and summary of an international meeting，8-9 September 2008［J］.Ann Oncol，2009，20(9)：1427-1482.
［21］Lee J，Suh C，Huh J，et al.Effect of positive bone marrow EBV in situ hybridization in staging and survival of localized extranodal natural killer/T-cell lymphoma，nasal-type［J］.Clin Cancer Res，2007，13(11)：3250-3254.
［22］Liu WS，Nan FF，Jia SS，et al.Detecting EB virus to determine curative effect in extranodal natu-ral killer/T-cell lymphoma［J］.Chin J Clin Oncol，2015，42（2）：105-108.［刘文硕，南飞飞，贾思思，等.结外NK/T细胞淋巴瘤检测EB病毒与疗效关系的研究［J］.中国肿瘤临床，2015，42（2）：105-108.］
［23］Wang HJ，Li H，Wang XF，et al.The correlation between extranodal NK/T cell lymphoma nasal type and Epstein-Barrvirus infection［J］.Med J Qilu，2014，29（6）：471-474.［王海娟，李慧，王笑峰，等.鼻型结外NK/T细胞淋巴瘤与ＥＢ病毒感染的相关性［J］.齐鲁医学杂志，2014，29（6）：471-474.］

Memo

Memo:
国家自然科学基金项目（编号：81472778）
Last Update: 2016-12-01