Luo Zhi-Guo, Feng Feng-Yi, Zhang Pin, Wang Xing-Yuan, Wang Qi-Lu
Department of Medical Oncology, Cancer Hospital/Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, P.R. China.
Ai Zheng. 2004 Dec;23(12):1692-5.
BACKGROUND & OBJECTIVES: Stomach is the most common extranodal involvement site of lymphoma. Treatment patterns for primary gastric lymphoma (PGL) are controversial now. This study was to investigate clinical features, treatment patterns, and prognostic factors of patients with PGL.
Records of 68 patients with PGL, including 37(54.4%) men,and 31(45.6%) women with a median age of 50(25-82) years,were retrospectively analyzed. Thirty-seven patients received surgery plus chemotherapy,7 received surgery plus chemoradiotherapy,9 received surgery plus radiotherapy,9 received surgery plus chemotherapy, 4 received surgery alone,and 2 were untreated. Survival rate was calculated by Kaplan-Meier method,prognosis factors were analyzed by univariate analysis, and Cox model multivariate analysis.
Common symptoms of PGL were abdominal pain, and weight loss. Common lesions of PGL were in gastric body, and gastric antrum. All 68 patients with PGL were diagnosed of non-Hodgkin's lymphoma (NHL) by pathology, which constituted about 3.4% of all gastric malignancies synchronously, 1 was T cell original, 67 were B cell original. Diagnosis rate of gastroscopy biopsy was 53.2%, that of X-ray barium meal was 40.9%. The overall 1-, 3-, and 5-year survival rates were 90.5%, 78.2%, and 75.7%, respectively. Univariate analysis showed that clinical stage (Ann Arbor), international prognostic index (IPI), and surgery were significant prognostic factors for PGL patients. Cox model multivariate analysis indicated that only surgery was independent prognostic factor for PGL patients.
Treatment of PGL should be based on combined therapy of surgery, chemotherapy, and radiotherapy. Surgery may be an independent prognostic factor for PGL patients.
胃是淋巴瘤最常见的结外受累部位。目前，原发性胃淋巴瘤（PGL）的治疗模式存在争议。本研究旨在探讨PGL患者的临床特征、治疗模式及预后因素。
回顾性分析68例PGL患者的病历，其中男性37例（54.4%），女性31例（45.6%），中位年龄50岁（25 - 82岁）。37例患者接受手术加化疗，7例接受手术加放化疗，9例接受手术加放疗，9例接受单纯手术，4例接受单纯手术，2例未接受治疗。采用Kaplan-Meier法计算生存率，单因素分析和Cox模型多因素分析预后因素。
PGL的常见症状为腹痛和体重减轻。PGL的常见病变部位为胃体和胃窦。68例PGL患者均经病理诊断为非霍奇金淋巴瘤（NHL），约占同期所有胃恶性肿瘤的3.4%，其中1例为T细胞来源，67例为B细胞来源。胃镜活检诊断率为53.2%，X线钡餐诊断率为40.9%。1年、3年和5年总生存率分别为90.5%、78.2%和75.7%。单因素分析显示，临床分期（Ann Arbor）、国际预后指数（IPI）和手术是PGL患者的重要预后因素。Cox模型多因素分析表明，仅手术是PGL患者的独立预后因素。
PGL的治疗应基于手术、化疗和放疗的综合治疗。手术可能是PGL患者的独立预后因素。
