Dworkin B, Lightdale C J, Weingrad D N, DeCosse J J, Lieberman P, Filippa D A, Sherlock P, Straus D
Dig Dis Sci. 1982 Nov;27(11):986-92. doi: 10.1007/BF01391744.
The records of 50 patients with localized primary gastric lymphoma were reviewed and clinical and prognostic factors characterized. Pathologic material was reclassified according to Rappaport's, Lukes-Collins, and Lennert's Kiel classifications. Factors with the greatest prognostic significance included initial stage as determined by surgery and pathology, absolute tumor size, degree of penetration through the stomach wall, and histologic grade of the lymphoma. After surgical resection for cure, the overall 5-year disease-free survival was 47%. For stage I disease, this was 78% vs 29% for stage II (P = 0.006). Patients with lymphomas less than 5 cm in diameter had 58% 5-year disease-free survival vs 32% for those with tumors greater than 10 cm (P = 0.06). Full-thickness penetration decreased 5-year survival from 75% to 38% (P = 0.06). Patients with histologically low-grade lymphomas had a better prognosis than those with high-grade lymphomas. The most significant correlation of histology to survival was seen with the Kiel classification with a 5-year survival of 39% for centroblastic polymorphous lymphoma vs 66% for LP immunocytoma. When lymphoma recurred it developed outside the abdomen in a majority of patients. The addition of abdominal radiation therapy to surgical resection made no significant impact on survival for either stage I or II disease.
回顾了50例局限性原发性胃淋巴瘤患者的记录，并对临床和预后因素进行了特征分析。病理材料根据Rappaport分类法、Lukes-Collins分类法和Lennert的基尔分类法重新分类。具有最大预后意义的因素包括手术和病理确定的初始分期、肿瘤绝对大小、胃壁穿透程度以及淋巴瘤的组织学分级。手术切除以治愈后，总体5年无病生存率为47%。对于I期疾病，这一比例为78%，而II期为29%（P = 0.006）。直径小于5 cm的淋巴瘤患者5年无病生存率为58%，而肿瘤大于10 cm的患者为32%（P = 0.06）。全层穿透使5年生存率从75%降至38%（P = 0.06）。组织学上低级别淋巴瘤患者的预后优于高级别淋巴瘤患者。组织学与生存的最显著相关性见于基尔分类法，中心母细胞多形性淋巴瘤的5年生存率为39%，而淋巴浆细胞性免疫细胞瘤为66%。当淋巴瘤复发时，大多数患者在腹部外发生。对于I期或II期疾病，手术切除加腹部放射治疗对生存没有显著影响。
