Liu Hui, Zhang Ru-peng, Li Fang-xuan, Quan Ji-chuan, Liang Han
Department of Stomach Oncology, Tianjin Medical University Cancer Institute and Hospital of Tianjin Medical University, Tianjin 300060, China.
Zhonghua Wai Ke Za Zhi. 2012 Feb 1;50(2):106-9.
To explore the clinicopathological characteristics and prognostic factors of primary gastric lymphoma (PGL).
The clinical data of 204 patients with PGL was reviewed and analyzed. There were 106 males and 98 females, their age were 19 to 85 years (average age was 53.7 years). The Focal areas included gastric fundus lesions 41 cases (20.1%), stomach body lesions 127 cases (62.3%), distal gastric lesions 105 cases (51.5%), cardia lesions 13 cases (6.4%), duodenal bulb lesion 1 cases (0.5%). The clinical characteristics and the outcomes in patients with influence were analysed.
In 204 PGL patients, the most common complaints were abdominal pain (62.3%) and weight loss (52.9%). Most of the PGL patients appeared ulcerative (76.0%) and results showed that 62.7% patients involved single location. As to the factors of cellulate grading and pathological characteristics, most patients (87.7%) show low-grade or intermediate-grade lymphoma, Musshoff stages I and II (74.0%). In 186 patients with complete follow-up data, survival rates of 1-, 3- and 5-year were 75.8%, 63.4% and 60.2% respectively. The median overall survival time was 50.0 months. In univariate survival analysis, age (χ(2) = 5.030), level of LDH (χ(2) = 40.084), cellulate grading (χ(2) = 35.238), Musshoff stage (χ(2) = 71.601), tumor diameter (χ(2) = 12.018) and option of managements (χ(2) = 14.140) were obviously correlated with the prognosis (all P < 0.05). Musshoff stage (RR = 2.230, 95%CI: 1.372 - 3.625) and cellulate grading (RR = 1.892, 95%CI: 1.010 - 3.543) were independent prognostic factors in multivariable analysis (both P < 0.05). There was no prognostic difference between surgery and chemotherapy in stage I and II (χ(2) = 1.223, P = 0.542).
Musshoff stage and grade malignancy are independent prognostic factors. For patients with stage I and II, surgical resection is not the first-choice for clinical therapy.
探讨原发性胃淋巴瘤（PGL）的临床病理特征及预后因素。
回顾性分析204例PGL患者的临床资料。其中男性106例，女性98例，年龄19至85岁（平均年龄53.7岁）。病灶部位包括胃底病变41例（20.1%）、胃体病变127例（62.3%）、胃远端病变105例（51.5%）、贲门病变13例（6.4%）、十二指肠球部病变1例（0.5%）。分析有影响患者的临床特征及结局。
204例PGL患者中，最常见的主诉为腹痛（62.3%）和体重减轻（52.9%）。大多数PGL患者表现为溃疡性（76.0%），结果显示62.7%的患者累及单一部位。关于细胞分级和病理特征因素，大多数患者（87.7%）表现为低级别或中级别的淋巴瘤，穆绍夫分期I和II期（74.0%）。186例有完整随访数据的患者，1年、3年和5年生存率分别为75.8%、63.4%和60.2%。中位总生存时间为50.0个月。单因素生存分析中，年龄（χ(2)=5.030）LDH水平（χ(2)=40.084）、细胞分级（χ(2)=35.238）、穆绍夫分期（χ(2)=71.601）、肿瘤直径（χ(2)=12.018）和治疗方式选择（χ(2)=14.140）与预后明显相关（均P<0.05）。多因素分析中，穆绍夫分期（RR=2.230，95%CI：1.372 - 3.625）和细胞分级（RR=1.892，95%CI：1.010 - 3.543）是独立的预后因素（均P<0.05）。I期和II期手术与化疗之间无预后差异（χ(2)=1.223，P=0.542）。
穆绍夫分期和恶性程度是独立的预后因素。对于I期和II期患者，手术切除并非临床治疗的首选。
