The Retrospective Analysis Of 51 Primary Gastrointestinal Lymphoma

Background:Primary gastrointestinal lymphoma(PGIL)is the most common extranodal lymphoma. The incidence of PGIL is relatively low. but which became a gradual upward trend. There were a few domestic reports of PGIL, and the clinical characteristics, diagnosis and treatment of which has not been fully understood.Objective:To analyze the clinical characteristics diagnosis, treatment and prognostic factors in patients with PGIL.Methods:51 patients with PGIL admitted to the First Affiliated Hospital of Chongqing Medical University from January 2009 to December 2013, were analyzed retrospectively.Results:(1) All patients included 29 males and 22 females, with the median age of 61 (range:19 to 87) years, and the sex ratio was about 1.32:1.(2) The main clinical symptoms of PGIL were abdominal pain (68.0%) and weight loss (35.3%), and could also manifested as abdominal distension, diarrhea, melena, hematochezia, dyspepsia, emaciation, anemia abdominal mass, etc.(3) 49 cases were examined by CT,48 cases had positive findings and 18 cases primary diagnosed PGIL.38 cases were examined by endoscopy,16 cases were primary diagnosed PGIL.(4) All patients were non-Hodgkin’s lymphoma.26 cases was primary gastric lymphoma (PGL) including 20 cases diffuse large B-cell lymphoma (DLBCL),5 cases extranodal marginal zone lymphoma of mucosaassociated lymphoid tissues lymphoma (MALTOMA), and 1 cases anaplastic large cell lymphoma (ALCL). Primary intestinal lymphoma (PIL) were 25 cases, including 21 cases DLBCL,1 case MALT lymphoma,1 case follicular lymphoma,1 case mantle cell lymphoma, and 1 was Burkitt lymphoma.(5) 46 PGIL patients received treatment.39 cases underwent surgical treatment, including 14 cases surgery alone,23 cases surgery combined with chemotherapy,2 cases surgery combined with chemotherapy and autologous hematopaietic stem cell transplantion.7 case were treated non-surgical treatment, including 6 cases chemotherapy alone,1 case chemotherapy combined with autologous hematopaietic stem cell transplantion.(6) Survival analysis showed that the 1-years and 2-years survival rates of patients with PGI-DLBCL was 67.7% and 57.1%.The patients with IPI<3, stage Ⅰ-Ⅱ,age< 60 years and the stomach lesions had a better prognosis (P<0.05)Conclusion:(1) PGIL often occurs in middle-age and old man. The clinical manifestations of PGIL have no specifically. The most common pathological subtype is DLBCL.(2) The endoscopy and imaging examination are the main examination measure at present. The definite diagnosis needs pathological, immunohisochemistry,and gene rearrangement examination if necessary.(3) IPI<3,stage Ⅰ-Ⅱ,age< 60 years old and the stomach lesions are positive prognostic factors.