原发性胃淋巴瘤临床病理因素与预后的关系

Relationship between the Prognosis and Clinicopathological Characteristics of Primary Gastric Lymphoma

目的分析原发性胃淋巴瘤（primary gastric lymphoma，PGL）预后与临床病理因素及治疗方式的关系。方法随访我院1991年5月-2006年12月44例接受手术治疗的PGL患者，用Kaplan-Meier生存分析、COX多因素分析研究预后与临床病理因素以及治疗方式的关系。结果手术切除率为88.64%，根治性切除率为79.55%。33例接受化疗，死亡1例。40例随访6月-15年，3年存活率为85.00%，5年存活率为67.24%。手术＋化疗患者3年存活率为86.35%，5年存活率为82.43%。细胞分级、周围器官或远处转移、手术方式、术后是否化疗是PGL的独立预后因素，其它临床病理因素不能作为独立预后因素。结论PGL的治疗应以手术、化疗为主，化疗可能更为重要，联合应用可以获得满意效果。细胞分级、周围器官或远处转移、手术方式、术后是否化疗可以预测其预后。

Objective To investigate the relationship between the clinicopathological characteristics, therapies and the prognosis of primary gastric lymphoma （PGL）. Methods The clinical data Was retrospectively analyzed in 44 PGL patients received surgical treatments from May 1991 to December 2006. The influence of each clinicopathological factor and therapy pattern on survival were assessed by Kaplan-Meier survival analysis and COX proportional hazard models. Results The resection rate was 88.64% , the radical resection rate was 79.55%. 33 cases received chemotherapy, One case died one week after operation. In 40 cases received 6-month to 15-year following up, the 3-year survival rate was 85.00% , the 5-year survival rate was 67.24%. And in the patients received chemotherapy, the 3-year survival rate was 86.35%, while the 5-year＇s was 82.43%. Grade of pathology, metastasis, operative pattern and chemotherapy were independent prognostic indicators for PGL. Conclusions Gastrectomy and chemotherapy may be the main therapeutic means for PGL, chemotherapy may be more important, gastrectomy combined chemotherapy can get good prognosis. Grade of pathology, metastasis, operative pattern, chemotherapy can predicate the prognosis for PGL.