Background

Studies on gastrointestinal (GI) tract involvement in mantle cell lymphoma (MCL) are lacking. We investigated the clinical characteristics and prognosis of MCL with GI tract involvement.

Methods

We retrospectively analyzed 64 patients diagnosed with MCL from January 2009 to April 2017. At the time of MCL diagnosis, patients who were identified to have GI involvement by endoscopic or radiologic examination were assigned to the GI-MCL group. The other patients were assigned to the non GI-MCL group.

Results

The GI-MCL group included 28 patients (43.8%). The most common endoscopic finding of MCL was lymphomatous polyposis (20/28, 71.4%). The GI-MCL group had higher stage and International Prognostic Index status (P = 0.012 and P = 0.003, respectively). Among the total 51 GI lesions in the GI-MCL group, 31.4% (16/51) were detected only by endoscopic examinations and were not detected on CT or PET-CT. The cumulative incidence of recurrence was higher in the GI-MCL group compared with the non GI-MCL group but the difference was not statistically significant (P = 0.082). Stage (HR 1.994, 95% CI 1.007–3.948) and auto PBSCT (HR 0.133, 95% CI 0.041–0.437) were identified as independent predictive factors for recurrence. Recurrences at GI tract were identified in 59.1% (13/22) and 11.1% (2/18) of the GI-MCL and non GI-MCL group, respectively. Among 15 GI tract recurrences, five recurrences were detected only with endoscopic examinations.

Conclusions

Endoscopy can reveal the GI involvement of MCL that is not visualized by radiological imaging. Endoscopic examinations are recommended during staging workup and the follow-up period of MCL patients.

中文翻译：

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胃肠道受累的套细胞淋巴瘤及其内镜检查的作用

背景

尚缺乏胃肠道（GI）涉及套细胞淋巴瘤（MCL）的研究。我们调查了胃肠道受累的MCL的临床特征和预后。

方法

我们回顾性分析了2009年1月至2017年4月诊断为MCL的64例患者。在MCL诊断时，通过内窥镜检查或放射学检查确定患有GI的患者被分配到GI-MCL组。其他患者被分配到非GI-MCL组。

结果

GI-MCL组包括28例患者（43.8％）。MCL最常见的内镜检查结果是淋巴瘤性息肉病（20 / 28，71.4％）。GI-MCL组的阶段和国际预后指数较高（分别为P = 0.012和P = 0.003）。GI-MCL组的全部51例GI病变中，仅通过内窥镜检查发现31.4％（16/51），而在CT或PET-CT上未检出。GI-MCL组的复发复发率高于非GI-MCL组，但差异无统计学意义（P= 0.082）。分期（HR 1.994，95％CI 1.007-3.948）和自动PBSCT（HR 0.133，95％CI 0.041-0.437）被确定为复发的独立预测因素。GI-MCL组和非GI-MCL组的胃肠道复发率分别为59.1％（13/22）和11.1％（2/18）。在15例胃肠道复发中，仅通过内窥镜检查发现5例复发。

结论

内窥镜检查可显示MCL的胃肠道受累，而影像学检查无法发现。在分期检查和MCL患者的随访期间，建议进行内镜检查。