Diagnosis and treatment of 81 patients with primary gastrointestinal lymphoma.

OBJECTIVE

To analyze the status quo of the diagnosis and treatments of primary gastrointestinal lymphoma (PGIL) in order to improve it.

METHODS

Eighty-one patients with PGIL were analyzed retrospectively including clinical manifestations, endoscopic features, pathological features, HP infection, treatment, and prognosis.

RESULTS

The age of patients with gastric lymphoma was (52.84+/-15.33) years. The age of patients with intestinal lymphoma was (42.09+/-15.28) years. Common symptoms included abdominal pain (76.5%), gastrointestinal bleeding (55.6%), anemia (54.3%), abdominal mass (25.9%), hypoproteinemia (40.7%), bowel obstruction (11.1%), abdominal distension, vomiting, and other non-specific gastrointestinal symptoms (32.1%), weight loss (33.3%); fever (8.6%), diarrhea (7.4%), digestive tract perforation (1.2%), constipation (1.2%), and dysphagia (1.2%). Endoscopic appearances were as follows: tumor type (67.7%), ulcer type (27.7%), and diffuse type (4.6%). Clinical diagnosis rate and endoscopic biopsy confirmation rate were 30.9% and 73.8%. MALT lymphoma accounted for 61.7% of the patients. HP detection rate was 39.5% and positive rate was 37.5%. A total of 69 patients received surgeries: 3 had preoperative chemotherapy, and 34 had postoperative chemotherapy. Twelve patients had non-surgical treatment, 6 patients of whom had simple chemotherapy and HP eradication therapy, and the other 6 gave up during the treatment. There was no significant difference in the survival rate of Stage I-II patients in the surgery alone group, surgery plus chemotherapy group, and chemotherapy and HP eradication therapy group(P>0.05). The survival rate of Stage III-IV patients in the surgery alone group was lower than that in the other 2 groups (P<0.05). The 5-year, 3-year, and 1-year survival rate was 55.87%, 70.96%, and 96.39%, respectively.

CONCLUSION

There are no specific clinical and endoscopic features in PGIL, so the misdiagnosis rate is high. Multi-site biopsy or repeated biopsies and immunohistochemical methods can be used to raise the pathological diagnosis rate. Chemotherapy and HP eradication are recommended.