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目的探讨结直肠原发性非霍奇金淋巴瘤(NHL)的诊断和治疗。方法回顾性分析2005至2011年收治的19例结直肠原发性NHL患者的临床资料,所有患者均经手术切除或探查病理活检证实。结果临床表现缺乏特异性,类似于同部位的结直肠癌。术前确诊率为57.9%(11/19),19例患者均行手术探查,手术切除率为89.5%(17/19),其中根治性手术为68.4%(13/19)。术后病理均诊断为非霍奇金淋巴瘤。临床分期I E期4例,II E期9例,III E期6例。15例患者术后辅以化疗,采用CHOP方案为基础的化疗方案,CD20阳性患者加用利妥昔单抗,化疗加放射治疗4例。结论结直肠原发性NHL术前诊断困难,早期诊断对改善预后十分重要,应综合临床表现、影像学及内窥镜检查结果,确诊依靠病理检查。治疗采用根治性手术切除联合CHOP为基础的方案化疗。
Objective To investigate the diagnosis and treatment of colorectal primary non-Hodgkin’s lymphoma (NHL). Methods The clinical data of 19 patients with primary NHL from 2005 to 2011 were retrospectively analyzed. All patients were confirmed by surgical resection or biopsy. Results The clinical manifestations of the lack of specificity, similar to the same site of colorectal cancer. The preoperative diagnosis rate was 57.9% (11/19). All the 19 patients underwent surgical exploration. The surgical resection rate was 89.5% (17/19), of which 68.4% (13/19) were radical surgery. Postoperative pathology were diagnosed as non-Hodgkin’s lymphoma. Clinical stage I E 4 cases, II E 9 cases, III E 6 cases. Fifteen patients received adjuvant chemotherapy followed by CHOP regimen-based chemotherapies. CD20-positive patients received rituximab plus chemotherapy plus radiotherapy in 4 patients. Conclusion The preoperative diagnosis of primary NHL in colorectal cancer is difficult. Early diagnosis is very important to improve the prognosis. Comprehensive clinical manifestations, imaging and endoscopic findings should be used to confirm the diagnosis. Treatment with radical surgical resection combined with CHOP-based regimen chemotherapy.