Comparative Analysis Of Clinical Features Between Primary Gastric Lymphoma And Gastric Adenocarcinoma

Objective: Primary Gastric Lymphoma(PGL) is one of the malignant extranodal lymphomas that initially presents in submucosal lymphoid follicles of the stomach wall. The percentage of PGL except gastric adenoearcinoma(GA) that both belong to gastric malignant tumor is 70% ~ 80%, which is second only to GA in the high incidence of gastric tumor, and in recent years has increased gradually. PGL relative to GA is not easy to be identified that both can principally manifest abdominal pain, abdominal distension, emaciation, gastrointestinal bleeding,which are bear similarity to the common with benign and malignant gastrointestinal disease. And relevant studies have shown that the rate of endoscopy diagnosis is still low, which is easy to cause clinical misdiagnosis, but the selection of treatment and prognosis of PGL differenced between stomach diseases, especially GA, so the early diagnosis of the disease is very important.This article is evaluating the differences of following parameter between PGL and GA, the incidence of PGL, general characteristics,imaging manifestations, endoscopic and pathological features and so on, which can clinically provides the reference for the early diagnosis and treatment of PGL, in order to improve prognosis.Methods: Retrospectively analyzed the patients with hospitalization diagnosis of PGA and GA in the first affiliated hospital of Dalian medical university from 2000 to2014. Comparative analyzing in the incidence of age, sex, clinical manifestations, HP infection, imaging and endoscopic performance, the pathological characteristics, etc.Results: 1. Both 62 cases of PGL and 195 cases of GA patients had atypicalclinical digestive manifestations and physical signs of abdominal pain,abdominal distension,,epigastric discomfort, gastrointestinal bleeding(P > 0.05),which are lack of specificity;2. The high age of incidence of PGL is 39 to 67 years old,multiple men than women, which is slightly younger than the GA group(P < 0.05); Course of PGL is relatively shorter than GA group(P < 0.05);3. The CT manifestations of PGL and GA is slightly different: PGL occurs in multiple sites simultaneously and extensive thickening in the stomach wall(P < 0.05);4. Combined with endoscopy and visible in the operation, PGL is given priority to with multiple lesions(P < 0.05),whose size is slightly larger than GA group(P < 0.05).And pathology type is given priority to with MALT and DLBCL; the mass of GA cases often located in antrum(P < 0.05);5. PGL misdiagnosis rate was higher than that of GA group on the accuracy of preoperative diagnosis(P < 0.05);6. The HP infection rate of GA is higher than the PGL group(P<0.05)which is the consistent with the related literature reports,referring to insufficient PGL group sample size.Conclusion: 1.Both PGL and GA have no obvious specificity of clinical manifestation and signs, imaging examinations are not typical, so the preoperative diagnosis which is still rely mainly on endoscopic biopsy and immunohistochemical analysis technology is not easy. It’s easier to early diagnosis by combining with computed tomography(CT). 2.PGL relative to GA is often happen to multiple parts and more diffused thickening in the lining of the stomach on CT which has indispensable value on the evaluation of the clinical staging and prognosis of disease;3. PGL mainly use surgery combined chemotherapy,some adopts pure chemotherapy and Hp eradication therapy, including one case cured by Hp eradication therapy that is getting more and more attention clinically.