Prognostic Analysis Of Primary Colorectal Non-Hodgkin’s Lymphoma

Purpose: Objective to investigate the clinical characteristics and prognostic factors of primary colorectal non-Hodgkin’s lymphoma.Methods:From January 2004 to December 2012,64 cases with primary colorectal were included in Shandong Cancer hospital.The clinical data including gender,age,pathological classification,tumor location,systemic symptoms,LDH level,clinical stage and treatment modalities were collected.SPSS 22 software was used to analyze the prognostic factors of univariate and multivariate analyses,P<0.05 was considered statistically significant.Results:All 64 patients were proved the non-Hodgkin’s lymphomas,40 males(62.5%)and 24 females(37.5%)with a male to female ratio of 5:3。55cases booted in B cell(85.9%),and 9 cases booted in T cell(14.1%).According to the general symptoms(fever of unknown cause was more than 38 C,night sweats and more than 10% weight loss in half a year),22 cases(34.4%)had systemic symptoms and 42 cases(65.6%)had no systemic symptoms.According to the level of lactate dehydrogenase(LDH),32 patients(50%)had higher level and 32 patients(50%)had normal level.The site of pathological changes among the 64 cases varied:36 in cecum(56.6%),18 in ascending colon(28.1%),4 in descending colon(6.3%),2 in transverse colon(3.1%),4 in rectum(6.3%)。The main methods of diagnosis were: 38 cases(59.4%)were diagnosed by surgical resection or intraoperative biopsy,14 cases(21.9%)were diagnosed by enteroscopy,12 cases(18.8%)were performed by abdominal puncture biopsy.There were 8 cases(12.5%)in stage IE,28 cas(43.8%)in stage IIE,8 cases(12.5%)in stage IIIE,20 cases(31.3%)in stage IVE.During the follow-up time,the overall 1-,3-,5-year survival rate of primary colorectal NHL patients was 78.1%、59.4%、46.9%.The univariate analysis showed that there was no statistically significant difference in five-year survival between sex differences,age,and tumor location;the difference in the five year survival rate between the systemic symptoms,the pathological classification(T/B),the lactate dehydrogenase(LDH)level,the clinical stage and the treatment methods had statistical significance.Multivariate analysis demonstrated that the pathological typing and clinical stage were correlated with prognosis.Conclusion:Primary colorectal non-Hodgkin’s lymphoma is a rare disease,has no specific clinical manifestations,the preoperative diagnosis is difficult,early diagnosis is very important in improving prognosis.Clinical diagnosis should be based on clinical manifestations,imaging and colonoscopy results,and the final diagnosis depends on pathological examination.Patients with systemic symptoms and/or high lactate dehydrogenase(LDH)levels have a poor prognosis.The pathological typing and clinical stage are closely related to the prognosie of primary colorectal non-Hodgkin’s lymphoma.The primary colorectal T-cell lymphoma is invasive,with a high degree of malignancy and a poor prognosis.The later the clinical stage,the worse the prognosis.Surgical treatment is an important diagnostic and therapeutic means for primary colorectal non-Hodgkin’s lymphoma.