원발성 장 림프종 52예의 치료결과와 예후인자
Primary Intestinal Lymphoma (Treatment Results and Prognostic Factors in 52 Cases)
대한암학회지 1998년 30권 1호 p.158 ~ 168
소속 상세정보
홍인철/In Chul Hong
류창학/노성훈/조장환/이경식/Chang Hak Yoo/Sung Hoon Noh/Chang Hwan Cho/Kyong Sik Lee
KMID : 0360319980300010158
Abstract
결론
장 림프종은 말단 회장, 회맹부, 우측대장, 공장 순으로 호발하며, 전체 5년 생존율이
41.4%인 예후가 불량한 종양이며, 그 중 공장이 가장 불량하였다. 초기병기의 장 림프종 32
예의 전체 5년 생존율은 48.4%로 위 림프종 41예의 82.9%보다 상대적으로 낮았다. 장 림프
종의 생존율은 병기에 따라 차이가 있었고, 다발성 병소, 인접장기 침범유무, 잔존암 유무
등과 관련이 높았으므로 생존율을 향상시키려면 조기진단하여 절제율을 높이고, 절제시 철
저한 림프절 곽청 및 잔존암이 없는 근치절제가 중요한 요소임을 알 수 있었다. 방사선 또
는 약물요법 또는 두가지 모두를 수술과 병용했을 경우가 수술단독보다는 관해율의 향상에
도움이 되었고, 초기 병기에서 생존율의 향상도 보였으나 비교군간에 증례가 적고 증례마다
적용 기준이 다양하여 향후 증례가 늘어야 각 치료방법 및 그 결과에 대한 비교연구가 가능
하리라 사료된다.
Purpose : In spite of many published reports about the primary gastrointestinal
lymphoma in Korea, the majority of them unfortunately involved a small number of
patients with diverse results concerning treatment, patient survival, and prognostic
factors. There also were few reports mainly focusing on primary intestinal lymphoma
alone. Therefore we studied the patient-survival and prognostic factors in 52 cases of
intestinal lymphomas.
Materials and Methods : We reviewed fifty two patients who received treatment due
to primary intestinal lymphoma at Severance hospital, from January 1980 to June 1995.
Results : The intestinal lymphomas were located in descending order of frequency at the
terminal ileum, ileocecal region, right colon, and the jejunum. The most common
histologic type was diffuse large cell type and the majority showed an intermediate
grade of differentiation. The average survival time was 40.7 months with a 5 year
survival rate of 41.4%. The overall and complete remission rate of the intestinal
lymphoma were 76.2%, 64.3%, respectively. Additional chemotherapy or radiotherapy to
surgery improved remission rate. The overall 5 year survival rates were 50.4%, 47.3%,
33.3%, and 25.0% in stage I, Ⅱ1, Ⅱ2 and Ⅲ-Ⅳ, respectively.
The 5 year survival rate after curative resection was 57.0% and 16.6% after incomplete
resection. The significant prognostic factors were residual tumor, site of the lesion,
multiplicity, and adjacent organ invasion. However, the site of the lesion alone (worst
in the jejunum) was the sole independent variable on multivariate analysis.
Conclusion : We concluded that early diagnosis and curative resection were important
to improve survival rates in the primary intestinal lymphoma. More number of such
cases are needed for further comparison of various treatment methods and results.
키워드
Primary intestinal lymphoma; Survival rate; Prognostic factors;
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