| Objective: To investigate the clinical characteristics and prognostic factors of primary gastric lymphoma( PGL),and the possible relationship between the clinical characteristics and prognostic factors with a retrospective analysis.Methods:1 All patients were diagnosed as PGL at Department of Hematology of Fourth Hospital of Hebei Medical University,from July 1993 to October 2013.Eighty-five cases with complete data were included in this study.2 Among 85 PGL cases,the ratio of male to female was 45:40(1.15:1).The median age was 57 years old.The course was 1-120 months, the median duration was 59 months. The main of first symptoms were abdominal pain and abdominal distension.The lesions occur in the body of stomach and gastric antrum.Pathological types were diffuse large B cell lymphoma and MALT lymphoma.85 patients were confirmed by endoscopy or operation pathology, were immunohistochemical examination. The clinical staging that commonly used was modified Ann Arbor stage.3 This group of 85 patients who underwent chemotherapy, chemotherapy with CHOP and CHOP solutions, including 11 cases of patients with chemotherapy combined with rituximab for targeted therapy, 1 patients combined with local radiotherapy and autologous peripheral blood stem cell transplantation, 31 cases of patients with chemotherapy before operation treatment, including subtotal gastrectomy and radical total gastrectomy.4 Data were analyzed by SPSS17.0 statistical software, using KaplanMeier analysis and Log-rank test for univariate survival analysis prognosis,multivariate analysis using Cox regression model.P < 0.05 for the difference had statistical significance.Results:1 This group of 85 patients were non Hodgkin lymphoma, no cases of Hodgkin’s lymphoma. Including 64 cases of invasive lymphoma(75.3%), 21 patients with indolent lymphoma(24.7%). Lesions located in the gastric fundus were 13 cases(15.3%), 60 cases of gastric body(70.6%), 39 cases of gastric antrum(45.9%), 5 cases of cardia(4.7%), which involved 52 cases of a single site(61.2%), two sites were involved in 29 cases(34.1%), 4 cases involving 3 and three the above parts(4.7%). According to Ann Arbor stage, stage I 27 cases(31.8%), 9 cases of stage II(10.6%), 8 cases of stage III(9.4%), 41 cases of stage IV(48.2%). 42 patients had B symptoms(49.4%), 43 cases without B symptoms(50.6%).2 In this group of 85 patients, 65 cases survived(76.4%), 20 cases of death(23.6%). Kaplan-Meier survival analysis showed that this group of patients, 1, 3, 5 year survival rates were 88.2%, 80.8%, 79.3%.3 The parameters of single factor analysis has significance on the prognosis including serum level of lactate dehydrogenase(LDH), clinical stage, serum levels of alpha hydroxybutyrate dehydrogenase(HBDH), B symptoms and serum beta 2- microglobulin(beta 2-MG), pathological type.The single factor analysis and multivariate regression analysis results in the significant parameters the Cox model, the results showed that serum level of alpha hydroxybutyrate dehydrogenase(HBDH), serum beta 2-microglobulin(beta 2-MG) and clinical stage were independent prognostic factors of survival in patients with gastric lymphoma.Conclusions: Serum beta 2- microglobulin(beta 2-MG), serum levels of alpha hydroxybutyrate(HBDH) and clinical stage were independent prognostic factors. |
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