| Objective:The clinical manifestations of primary gastric lymphoma(PGL) are nonspecific,it is difficult to be distinguished from other gastointestinal tumors,which results in frequent misdiagnosis.The standard chemotherapy regimen for PGL is uncertain.This study was to analyze the clinical characteristics and prognosis of PGL,which may benefit its early diagnosis,early treatment and improve the prognosis.Methods:The medical records of 40 PGL patients in The First Affiliated Hospital of Guangxi Medical University from Apr.2003 to Apr.2008 were analyzed retrospectively,and their clinical data were analyzed by Kaplan-Meier method and log -rank test.Results:The median age of the 40 patients was 49.5 years(13-77),and the ratio of sex(male:female ) was 1:1.The main gastrointestinal manifestation was epigastric pain with infrequent systemic symptoms.Endoscopically,the lesions observed are large,more extensive,involving multiple sites,and were located mainly in the antrum and body of stomach.The diagnosis rate of biopsy specimen pathology was 61.3%.29 cases(72.5%) were diagnosed as diffuse large B cell lymphoma(DLBCL) and only 2 cases(5%) were diagnosed as MALT lymphoma.9 cases underwent radical operation or palliative operation,16 cases received operation + chemotherapy.Among the 34 patients who had been followed up,11(32.4%)died,median for survival time was 37 months,the 3- and 5-year survival rates were 56.9%and 49.8%, respectively.Log -rank test revealed that clinical stage,tumor size,depth of invasion,level of PLT and treatment methods were important prognostic factors of PGL(P＜0.05).Conclusions:PGL is misdiagnosed frequently.Preoperative diagnosis depends mainly on gastroscopy with biopsy.Multiple and deep biopsy should be used to improve the endoscopic diagnosis rate.The therapeutic regimen should be selected in accordance with histological type,clinical staging,and the presence of Helicobacter pylori infection.Early treatment and surgery combined with chemotherapy can improve survival rate.
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