Clinical Features And Prognostic Factors Of 90 Patients With Primary Small Intestinal Lymphoma Confirmed By Pathology

Objective: To explore the clinicopathological features,treatment methods and characteristics of primary small intestinal lymphoma(PSIL),and to analyze the prognosis,so as to provide some clinical basis for diagnosis and treatment.Methods: Clinical data of patients with PSIL confirmed by endoscopy or surgical pathology in the first affiliated hospital of Chongqing medical university from August 2011 to September 2018 were retrospectively analyzed.The prognostic factors affecting survival rate were treated by Kaplan-meier method,Log-rank test and Cox regression analysis.Results: Among the 90 patients,the male to female ratio was 7:3,the median age was 58.5(43.50,66.25)years.The clinical manifestations lack specificity,the most common symptom was abdominal pain,with 68 cases(75.6%).Single lesions occurred in 64 cases(71.1%),most commonly in terminal ileum(38/64,59.4%).All the 90 cases were non-hodgkin's lymphoma,including 87 cases of B-cell lymphoma(96.7%).Diffuse large B-cell lymphoma was the most common type(64.4%).The coincidencerate between PET-CT and pathology was 100%.A total of 41 patients(45.6%)received surgery and chemotherapy,29 patients received chemotherapy alone(32.2%),and 12 patients received surgery alone(13.3%).The the median survival time was 50.00 months,survival rate of1-year and 3-year were respectively 75.1%,65.2%.Univariate analysis showed that the age ?60 years old(P=0.026),Lugano stage ?IIE(P=0.008),IPI score ?3 points(P<0.001),CD20 positive patients used rituximab(P=0.047),ki67>40%(P=0.044)and treatment mode(P<0.001)all had effects on survival and prognosis.IPI score ?3 points(P=0.018)was an independent risk factor affecting PSIL prognosis.Conclusion: PSIL is mostly seen in middle-aged and elderly men,with insipid onset and atypical clinical manifestations.Abdominal enhanced CT and PCT-CT can assist in the detection of lesions and clinical staging.The treatment should be selected individually according to the patients' clinical manifestations,staging,and pathological classification.IPI score ?3 points was an independent risk factor affecting PSIL prognosis.