| Objective: To investigate the clinical characteristics, diagnosis, treatment and prognosis of primary gastrointestinal lymphoma(PGIL).Methods: Forty PGIL patients were collected from January 1993 to January 2003 admitted to General surgery Department of Qilu Hospital, and their clinical characteristics , diagnosis , treatment and prognosis were analyzed retrospectively.Results: The main clinical manifestations of PGIL were abdominal pain, blackstools, anemia, weightloss, abdominalmass, nausea and vomiting, abdominal distension, loss of appetite. Histopathological examination revealed that mucosa associated lymphoid tissue (MALT) lymphoma, accounted for the largest proportion of the patients, of 47. 5%, followed by diffuse large B-cell lymphoma(DLBCL), of 40%. The preoperative diagnostic rate was 50%; the diagnostic rate of the following accessory examinations are X-ray contrast radiography 3.7%(1/27), CT 19.4%(6/31), gastrointestinal endoscopy 41. 4%(12/29), endoscopic ultrasonography 100% respectively. All the patients in this group were treated with operation, 26 cases received comprehensive treatment after operation. The 5-year survival rate of this group is 55%. The differences of 1-year, 3-year, 5-year survival rate between low grade malignant group and high grade malignant group had statistical significance(P<0. 05). The differences of 1-year, 3-year, 5-year survival rate between stageâ… and stageâ…¡didn't have statistical significance(P>0.05). The differences of 1-year, 3-year, 5-year survival rate between stageâ… +stagâ…¡and stageâ…¢+stageâ…£had statistical significance(P<0.05).The differences of 1-year, 3-year, 5-year survival rate between the post-operative comprehensive treatment group and only operation group had statistical significance(P<0. 05). The differences of 1-year, 3-year, 5-year survival rate between theradical operation and palliative operation group had statistical significance (P<0.05).Conclusion: PGIL lacks specific manifestations, so it's hard to make preoperative diagnosis. Endoscopic ultrasonography and immunohistochemistry may improve the diagnostic rate. Pathological types, clinical stage, operative method and post-operative comprehensive treatment are close related with prognosis. Post-operative comprehensive treatment can increase survival rate clearly. |
