Clinicopathological Characteristics And Prognostic Analysis Of Primary Intestinal Lymphoma

Objective: The aim of our study is to evaluate the clinical presentation,histological type,treatment and prognosis of primary intestinal lymphoma(PIL).Meanwhile,our study focus on the research of primary intestinal diffuse large B cell lymphoma(PIDLBCL),which is the most common pathological type of PIL.An assessment of prognosis for PI-DLBCL was analyzed,and prognostic factors including the score of international prognostic index(IPI),clinical stage and immunological classification,etc.Methods: 82 patients with a diagnosis of PIL were enrolled in our observational cohort.The clinicopathological data of PIL were collected from 2003 to 2015 in our hospital.In accordance with World Health Organization(WHO)classification and Lugano staging system,we defined cases as different pathological types and clinical stages.Furthermore,our study devided PIL into intestinal B cell lymphoma(IBCL)and intestinal T cell lymphoma(ITCL)to perform a statistical comparison.At the same time,we made a retrospective analysis of clinicopathological characteristics of PI-DLBCL.According to the score of IPI,Hans model,Lugano staging system and Paris staging system,we defined cases as different risk grading,immunophenotyping and clinical stages to analyze the prognosis of PI-DLBCL.Results: Among the 82 patients with a diagnosis of PIL,68 patients(82.9%)suffered from IBCL and 14 patients(17.1%)suffered from ITCL.The predominant pathological type of PIL was diffuse large B cell lymphoma(DLBCL),a total of 49 cases(59.8%).PIL was most common in the small intestines(45.1%),followed by the colorectum(26.8%).The univariate prognostic analysis of PIL revealed that patients with normal serum albumin and lactate dehydrogenase(LDH)levels,Lugano I/II stages,immunophenotyping as IBCL and treatment combined surgery with chemotherapy had better prognosis(P=0.009,0.002,0.003,<0.001 and <0.001,respectively).The multivariate prognostic analysis of PIL revealed that the serum albumin level,Lugano stages,immunophenotyping and the therapeutic schedule were significant predictive factors for prognosis of patients(P=0.012,0.017,0.002 and <0.001,respectively).According to the univariate prognostic analysis,the patients of PI-DLBCL had a better prognosis with characteristic such as: normal serum lactate dehydrogenase(LDH)level,surgical treatment,low/low-intermediate risk group,Lugano I/II stages,T2 stage and M0 stage of Paris staging system(P=0.008,0.008,0.002,0.013,0.023 and 0.037,respectively).Conclusions: The patients of PIL could benefit a better prognosis from normal serum albumin and LDH levels,early clinical stage(Lugano I/II stages),immunophenotyping as IBCL and treatment combined surgery with chemotherapy.The overall survival of normal serum LDH level in patients with PI-DLBCL was longer.Besides,surgical resection of the lesion could prolong the the overall survival of patients with PI-DLBCL.In terms of PI-DLBCL,the score of IPI,Lugano staging system,T and M stages of Paris staging system could all contribute to the evaluation of the prognosis.