胃と腸45巻8号

2010年07月発行

今月の主題 直腸肛門部病変の鑑別診断─最新の知見を含めて 主題

直腸悪性リンパ腫の臨床病理学的特徴

著者： 中村昌太郎¹ 梁井俊一¹ 藤田恒平² 平橋美奈子² 中村滋郎³ 藤澤律子¹ 松本主之¹

所属機関： ¹九州大学大学院病態機能内科学 ²九州大学大学院病形態機能病理学 ³新日鐵八幡記念病院消化器科

ページ範囲：P.1359 - P.1370

要旨　直腸悪性リンパ腫23例（MALTリンパ腫9例，濾胞性リンパ腫3例，マントル細胞リンパ腫1例，びまん性大細胞型B細胞リンパ腫4例，T細胞性リンパ腫6例）の臨床病理学的特徴を遡及的に解析した．肉眼型と組織型に相関がみられ，隆起型ではMALTリンパ腫，びまん型・混合型ではT細胞性リンパ腫，MLP型では濾胞性リンパ腫が高頻度にみられた．非外科的治療群（化学療法，放射線，抗菌薬，無治療 ; n＝15）と外科的切除群（n＝8）では予後に差はなかった．多変量解析の結果，組織学的低悪性度（indolentリンパ腫）がoverall survivalおよびevent-free survival（EFS）のいずれにおいても独立した予後良好因子であった．穿孔，B症状，B/T免疫表現型，臨床病期はEFSのみを規定する要因であった．

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