| Objective:To explore the clinical differences between primary and secondary intestinal lymphoma,and to provide a basis for the accurate diagnosis between the two.Methods:Retrieval in January 2000 to August 2018 cases of our hospital during the period of lymphoma,screened by pathological diagnosis of intestinal lymphoma patients,ruled out after clinical system evaluation can not be sure whether it is the primary or secondary to intestinal lymphoma,Dawson,standard in selected patients are classified as the primary group,patients classified as secondary groups,compared two groups of patients in the general information,clinical manifestation,laboratory examination,lesion characteristics,pathologic type and malignant degree of differences,and statistical analysis.Results:(1)General information: 102 cases were included.There were 56 cases in primary group,39 cases in male and 17 cases in female,46 cases in secondary group,32 cases in male and 14 cases in female.The mean age of the primary group was60.5 9.1,and the mean age of the secondary group was 53.9 10.7.The difference between the two groups was statistically significant(?2=2.26,P=0.032).The most common age in the primary group was 45-54 years old,and the most common age in the secondary group was 65-74 years old.The difference between the two groups was statistically significant(?2=0.96,P=0.33;?2=0.79,P=0.37).(2)Clinical manifestations: abdominal pain was the most common in both groups;abdominal pain was 41 in primary group and 23 in secondary group,with significant difference(?2=5.82,P=0.016);abdominal distension was 12 in primary group and 19 in secondary group,with significant difference(?2=4.72,P=0.03);symptoms of digestive system were 1 in primary group and 6 in secondary group,with significant difference(?2=5.01,P=0.025);There were 10 cases with B symptoms and 18 cases with secondary symptoms(?2=5.74,P=0.017).(3)Laboratory examination: LDH elevated in 13 cases in primary group and 21 cases in secondary group,with significant difference(?2=5.72,P=0.017);?2-microglobulin elevated in 5 cases in primary group and 11 cases in secondary group,with significant difference(?2=4.29,P=0.038).(4)Lesion features: 26 cases of primary group and 31 cases of secondary group were mainly mass type,with significant difference(?2=4.5,P=0.034);21 cases of ileocecal lesions in primary group and 7 cases of secondary group,with significant difference(?2=6.30,P=0.012);6 cases of primary group and 14 cases of secondary group,with significant difference(?2=8.14,P=0.0043).There were2 cases of duodenal involvement in the primary group and 7 cases in the secondary group(?2=4.26,P=0.039).(5)Pathological types: diffuse large B-cell lymphoma was the most common type in both groups;extranodal NK/T-cell lymphoma was more common in primary group(?2=7.4,P=0.006);mantle cell lymphoma was more common in secondary group(?2=5.07,P=0.02).(6)Malignant degree: High malignant lymphoma was predominant in both groups;there was no significant difference between the two groups in the degree of malignancy;in patients younger than 60 years old,20 cases were highly malignant in the primary group(100%)and 24 cases were highly malignant in the secondary group(96%).Both groups were highly malignant,and the proportion of high malignant in the primary group was higher with significant difference(?2=4.07,P=0.04).Conclusion:Compared with primary intestinal lymphoma,secondary intestinal lymphoma is younger,abdominal distention,B symptoms,or without digestive tract symptoms are more common.LDH and ?2-microglobulin are significantly increased.Colon is the most involved,mantle cell tumors are common,and the high malignant degree of patients younger than 60 years old is lower. |
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