Analysis Of87Cases Primary Gastrointestinal Lymphoma

Objectives: To investigate the clinical characters of Primary GastrointestinalLymphoma, and improve the diagnostic rate and standard treatment by analyzing theclinical data of primary gastrointestinal lymphoma.Methods:87patients confirmed by pathology and admitted to the First AffiliatedHospital of Dalian Medical University from January1999to December2010,wereanalyzed retrospectively.Results:(1)General Informations: All patients included45males and42females.Thesex ratio was1.07:1.The age of patients ranged from15-87years old, the mean age was57.3±16.1years old. There were46cases stomach lesions (52.3%),37cases smallintestinal lesions(42.5%),4cases colonic lesions(4.6%).(2)Clinical Symptoms:the mostcommon symptoms was abdominal pain(62.8%),other common symptoms include:11cases of bloody diarrhea,11cases of diarrhea,14cases of nausea,6cases of vomiting,28cases of weight loss.There were23cases who had perforation,obstruction and othercomplications in Primary small intestinal lymphoma,accounting for56.1%.(3)Assistantexaminations: There were50cases of anemia(57.5%),including39cases of mild anemia,10cases of moderate anemia,1case of severe anemia,and the mean HB (hemoglobin)was109.7g/L.In the30cases of Primary gastrointestinal lymphoma with abdominalCT examination, there were25cases of positive findings including5cases diagnosedPGL.In the33cases of PGL with abdominal CT examination, there were29cases ofpositive findings including3cases diagnosed PSIL.(4)Pathological stage: All patientswere non-Hodgkin’s lymphoma. PGL were46cases including31cases B-celllymphoma of mucosa-associated and14cases diffuse large B-cell lymphomas, one casewas not immunohistochemical clear type. PSIL were41cases, which29cases were Bcell origin,6cases were T cell-derived,6patients were not explicitly typing.(5)Clinicalstage: According to the modified Ann Abor staging, IE:46cases, II E:31cases, stageⅢ:4cases, Ⅳ:6cases.(6)Diagnosis:33cases of patients initially diagnosed with PGIL diagnosis rate was37.9%, of which the diagnosis rate of gastric lesions was56.5%andthe diagnosis rate of intestinal lesions was17.1%.(7)Treatment:70cases of all patientsunderwent surgical treatment,15cases were treated non-surgical treatment,2cases gaveup treatment.32cases of gastric lesions underwent surgery,including27cases of radicalsurgery and5cases of palliative resection.And there were18patients who treated bysurgery alone,10patients who treated by postoperative combined with CHOP(phosphoric acid amide+doxorubicin+vincristine+prednisone) therapy,4patientswho treated by surgery combined with R-CHOP (rituximab+phosphoric acid amide+doxorubicin+vincristine+prednisone) therapy;13cases were treated by non-surgicaltreatment,including3cases of CHOP,7case of R-CHOP,2cases of simpleanti-Helicobacter pylori therapy,1case abandon treatment. Intestinal lesions underwentsurgery38cases,including15cases of radical right colon resection,16cases of smallbowel resection,7cases of palliative resection.And there were17cases of surgeryalone,17cases of surgery combined with CHOP therapy,4cases of surgery combinedwith rituximab.Two cases of non-surgical treatment were treated by R-CHOP program,one patient gave up treatment.(8)The prognosis:64patients out of87patients werefollow-up and the follow-up rate was73.6%, the overall one-year survival rate was82%,3-year survival rate of77%; expected average survival time was86.5months,univariate analysis showed that the stomach lesions, early clinical stage, pathologicaltype of B-cell origin were positive prognostic factors, multivariate analysis found thatoverall survival was related to clinical stage, histological type.Conclusions:1.The stomach lesions in the PGIL were common than the intestinallesions.And the stomach lesions always occured in the gastric body and antrum, theintestinal lesions always occured in the ileum, especially in the terminal ileum.2.Theclinical symptoms were not significant characteristics. PSIL patients prone toperforation, obstruction, intussusception and other complications.3.Non-Hodgkin’slymphoma was the main pathology type, which mostly originated B cell-derivedcell.4.Treatment options included surgery, chemotherapy, biological therapy andcombined therapy.5.Overall survival was related to clinical stage, histological type.