Analysis Of46Cases Of Primary Gastric Lymphoma

Objective: To explore the clinical characters of primary gastric lymphoma, improve thediagnosis and treatment levels of primary gastric lymphoma.Methods:46patients which were primary gastric lymphoma in the First AffiliatedHospital of Dalian Medical University from July2002to October2011were collected,their clinical manifestations, diagnosis, pathological features, treatment and follow-updata were retrospectively analysed.Results: There were46patients in this group, which17were males and29werefemales, aged from20~77years old, the mean age was54years old. There were40cases of single-site lesions (87%), which20cases in gastric antrum (50%),16cases ingastric body (40%),3cases in gastric fundus (7.5%),1case in cardiac (2.5%). Therewere3cases of two site lesions (6.5%), and3cases of more than two site lesions(6.5%). Clinical manifestations include upper abdominal pain, abdominal discomfort,nausea and acid reflux, vomiting blood, sense of choking after eating, with weight loss,melena, and so on. The most common symptom was upper abdominal pain (69.5%),with weight loss (24%). The most common performance under endoscopy was singlelarge ulcers (74%),40cases with single-site involvement (87%), and the most commonsite was gastric antrum. All the46cases of primary gastric lymphoma were B-celllymphoma, which30cases were gastric mucosa-associated lymphoid tissuelymphoma(65.2%),14cases were diffuse large B-cell lymphoma(30.4%),1case wasgastric mucosa associated lymphoid tissue lymphoma with diffuse large B-celllymphoma(2.2%),1patient was not explicitly be typed. Clinical stage:22patients werestage I (48%),18patients were stage II (39%),3patients were stage III (6.5%),3patients were stage IV (6.5%). In46patients, there were32patients were treated withsurgery, which14cases combined with postoperative chemotherapy,18cases withsurgery alone. In46patients, there were13patients were treated with chemotherapy alone. There was no significant difference between Age <60-year-old patients and age≥6060-year-old patients in1-year survival rate, whereas that of3-year survival rate thedifference was significant (p <0.05). The difference between stage I,II and stage III,IVpatients in1-year and3-years survival rate were statistical significance. The differencebetween MALT lymphoma and DLBCL in1-year and3-years survival rate werestatistically significant. There was no significant difference between patients receivedsurgery combined with chemotherapy group and patients with chemotherapy alonegroup in1-year and3-year survival rate, which implicated that operation is no longerthe preferred method of treatment in Phase I and II primary gastric lymphoma.Conclusion:：The upper abdominal pain is the most common clinical manifestations ofthe primary gastric lymphoma patients, often accompanied with weight loss. Endoscopywas the main way to check, the most common performance under endoscopy was singlelarge ulcers, the gastric antrum is the ordinary site. The most common pathological typewas gastric mucosa-associated lymphoid tissue lymphoma and diffuse large B celllymphoma. Age, pathological type, clinical stage and treatment methods were theprognosis factors. We stand for the comprehensive treatment of chemotherapy in stage Iand II primary gastric lymphoma, and the use of rituximab (MabThera) can improve theprognosis of primary gastric lymphoma patients.