Huang Jin, Zhong Meizuo, Tang Youhong, Lu Jianhong, Li Xiaoling, Li Guiyuan
Department of Oncology, Xiangya Hospital, Central South University, Changsha, China.
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2012 Oct;37(10):997-1002. doi: 10.3969/j.issn.1672-7347.2012.10.005.
To analyze the clinical characteristics of primary gastric lymphoma (PGL) and to improve its diagnosis and treatment.
The clinical manifestations, diagnosis, treatments and history of 50 PGL patients, who were hospitalized from September 2005 to September 2009, were reviewed and analyzed.
The main manifestation of PGL was epigastric pain with infrequent systemic symptoms, such as stomach ache, abdominal discomfort, vomit, black stool, loss of appetite, fever, feeble, and skinny. Pathological examination indicated that only 1 patient had T cell lymphoma while the rest 49 had B cell lymphoma. Fourteen had mucosa-associated lymphoid tissue lymphoma (MALT), 35 had diffuse large B cell lymphoma (DLBCL), and 2 had both DLBCL and MALT (DLBCML). All the 50 patients received chemotherapy, and 12 underwent surgical treatment besides chemotherapy. Fourteen out of the 49 patients with B cell lymphoma received rituximab together with chemotherapy, and 35 received chemotherapy alone. The 2-year survival rate in the patients receiving rituximab together with chemotherapy was higher than that in the patients receiving chemotherapy alone (85.7% vs 77.1%, P< 0.05). The 2-year survival rate in patients of clinical stage I-II was higher than that in patients of clinical stage III-IV (90.9% vs 71.4%, P< 0.05).
The main clinical manifestation of PGL patients is non-specific gastrointestinal symptoms, among which abdominal pain is most common. The clinical examination mainly relies on pathological examinations, and the most common pathological type of primary gastric lymphoma is DLBCL. The main treatment is chemotherapy, and the prognosis is related to the clinical stage and the use of rituximab. After the treatment, the 2-year survival rate in the 50 patients reaches 80.0%.
分析原发性胃淋巴瘤（PGL）的临床特征，以提高其诊断与治疗水平。
回顾性分析2005年9月至2009年9月期间收治的50例PGL患者的临床表现、诊断、治疗及病史。
PGL的主要表现为上腹部疼痛，全身症状较少见，如胃痛、腹部不适、呕吐、黑便、食欲不振、发热、乏力及消瘦。病理检查显示，仅1例为T细胞淋巴瘤，其余49例为B细胞淋巴瘤。14例为黏膜相关淋巴组织淋巴瘤（MALT），35例为弥漫性大B细胞淋巴瘤（DLBCL），2例同时存在DLBCL和MALT（DLBCML）。50例患者均接受了化疗，其中12例在化疗的基础上接受了手术治疗。49例B细胞淋巴瘤患者中，14例接受了利妥昔单抗联合化疗，35例仅接受化疗。接受利妥昔单抗联合化疗患者的2年生存率高于单纯化疗患者（85.7%对77.1%，P<0.05）。临床Ⅰ-Ⅱ期患者的2年生存率高于临床Ⅲ-Ⅳ期患者（90.9%对71.4%，P<0.05）。
PGL患者的主要临床表现为非特异性胃肠道症状，其中腹痛最为常见。临床检查主要依靠病理检查，原发性胃淋巴瘤最常见的病理类型为DLBCL。主要治疗方法为化疗，预后与临床分期及利妥昔单抗的使用有关。50例患者治疗后的2年生存率达80.0%。
