Clinical Features And Prognosis Of Primary Gastric Lymphoma

Objective: This study aimed to analyze the clinical characteristics and prognostic factors in patients with primary gastric lymphoma(PGL)Methods:The clinical data and prognosis of 207 patients with PGL diagnosed by Department of Hematology,The Fourth Hospital of Hebei Medical University from July 2010 to July 2020 were retrospectively collected and analyzed.Results:1.The pathological types of 207 cases of primary gastric lymphoma(PGL)were: 149 cases(71.98%)of diffuse large B cell lymphoma(DLBCL),45 cases(21.74%)of(mucosa-associated lymphoid tissue,MALT)lymphoma,5 cases(2.42%)of peripheral T-cell lymphoma,3 cases(1.45%)of NK/T-cell lymphoma,2 cases(0.97%)of diffuse large B-cell lymphoma transformed from follicular lymphoma,1 case(0.48%)of Burkitt lymphoma,1 case(0.48%)of mantle cell lymphoma and 1 case(0.48%)of plasmablastic lymphoma.The most common pathological types were DLBCL and MALT lymphoma;2.There were 143 PGL patients with complete treatment and follow-up data,including 111 cases of DLBCL and 32 cases of MALT lymphoma.There were 105 cases of pure DLBCL and 27 cases of DLBCL with MALT component.The median age of 143 patients with PGL was 54 years old(17-84 years old),The antrum and corpus were the most commonly involved site.The most common symptoms of PGL in the present study were abdominal pain,abdominal distention,acid regurgitation,nausea and vomiting.The 143 PGL patients had a five-year overall survival(OS)and progression free survival(PFS)of 84.0% and 77.4%.There was no significant difference in OS and PFS between gastric DLBCL and gastric MALT;3.The 111 patients with gastric DLBCL had a five-year overall OS and PFS of 80.7% and 76.3%.The median follow-up time was 42 months.Age>60years old,advanced stage and decreased albumin levels were associated with worse OS and PFS in univariate analysis.International Prognostic Index(IPI)score >2,elevated β2-microglobulin levels were associated with worse OS in univariate analysis.Gastric DLBCL patients with elevated LDH or non-GCB subtypes have a tendency to shorten OS.Cox regression analysis showed that age and stage were independent predictors of survival.4.The 32 patients with gastric MALT lymphoma had a five-year OS and PFS of 96.9% and 79.8%.The median follow-up time was 34.5 months.Advanced stage,elevated β2-microglobulin levels and decreased albumin levels were associated with worse OS and PFS in univariate analysis.Cox regression analysis showed there were not independent predictors of survival.5.Rituximab were not associated with OS and PFS of gastric DLBCL(P=0.542;P=0.968).Surgery were not associated with OS and PFS of gastric DLBCL.(P=0.385;P =0.537)Conclusions:1.PGL is common in middle-aged and elderly patients,especially.The antrum and corpus were the most commonly involved site.It often presents with abdominal pain,abdominal distention,acid regurgitation,nausea and vomiting.2.Age,stage,International prognostic index score,β2-microglobulin,LDH,albumin were associated with the prognosis of gastric DLBCL.Age and stage were independent prognostic factors.The prognosis of gastric DLBCL patients with elevated LDH or non-GCB subtypes tends to poor..3.Stage,β2-microglobulin and albumin were associated with the prognosis of gastric MALT lymphoma4.The addition of rituximab or surgery was not found to have an impact on patients’ outcomes with primary gastric DLBCL...