Clinical Characteristics And Prognostic Factors Of Primary Gastric Lymphoma

Objective: To investigate the clinical features and prognostic factors of patients with primary gastric lymphoma.Methods: The data of patients with primary gastric lymphoma diagnosed in the First Affiliated Hospital of Guangxi Medical University from January 1,2013 to June 31,2018 were retrospectively analyzed.Kaplan-meier method was used for univariate prognostic analysis,log-rank test was used for inter-group comparison,and Cox regression model was used for multivariate analysis.Results: The 49 patients with PGL were enrolled in this study,with a median age of 52 years and a male-to-female ratio of 1.45:1.The clinical symptoms of 49 patients with PGL included 39 cases of abdominal pain,18 cases of anorexia,15 cases of abdominal distension,14 cases of emaciation,10 cases of acid regurgitation,9 cases of melena or hematochezia,8 cases of nausea and vomiting,4 cases of hematemesis and 1 case of abdominal mass.All 49 patients were non-Hodgkin's lymphoma,31 diffuse large B-cell lymphoma,13 MALT lymphoma,2 Burkitt's lymphoma,1 plasma cell lymphoma,1 invasive B-cell lymphoma and 1 ALK-negative anaplastic large cell lymphoma.The lesions were mostly found in the gastric body and the gastric antrum,and the lesions in multiple sites were more common than thosein single sites,simple involving the stomach bottom in 1 case,6 cases of gastric body,gastric Angle in 1 case,10 cases of gastric antrum,stomach gastric antrum junction in 1 case,and the rest of the 30 cases of multiple parts of the lesion,endoscopic performance for ulcer type 17 cases,nodular type 16 cases,the uplift or neoplasm infiltrating lesions in 5 cases,endoscopic biopsy diagnosis rate was 87.76%.Two cases were lost,and the average survival time of 47 patients was 60.35 months(95% CI 53.01-67.69).The 1-year,2-year and3-year survival rates were 84.70%,81.90% and 81.90% respectively.Univariate analysis showed that Lugano stage ?E-?(P=0.022),IPI score 3-5(P=0.013),CA125 increase(P=0.008),LDH increase(P=0.000)were the adverse prognostic factors of patients with PGL.Multivariate analysis showed that LDH was the independent factor affecting the survival rate of patients(P=0.028,RR=15.509,95% CI:1.345-178.848).Conclusions: 1.Primary gastric lymphoma is common in middle-aged and elderly men.It mainly occurs in the gastric body and antrum.The main clinical symptoms are abdominal pain,abdominal distension,poor appetite and emaciation.The main pathological types are diffuse large B cells and MALT.2.Ulcer,nodular eminence or mass are the most common endoscopic manifestations in patients with PGL.Endoscopy and biopsy are important means for the diagnosis of PGL.3.The prognostic factors of patients with PGL include clinical stage,IPI score,LDH and CA125.LDH is the independent prognostic factor of patients with PGL.