原发性胃淋巴瘤58例临床诊治及其预后影响因素分析

Clinical treatment and prognosis of 58 cases of primary gastric lymphoma

目的探讨原发性胃淋巴瘤(PGL)的临床特征和影响预后的相关因素。方法回顾性分析我院58例原发性胃淋巴瘤患者的临床、胃镜、病理及随访资料,采用单因素和多因素方法分析影响预后的相关因素。结果本组患者胃镜下肿瘤好发于胃窦及胃体,黏膜相关淋巴组织淋巴瘤(MALToma)和弥漫大B细胞淋巴瘤(DLBCL)是主要病理类型,1、3、5年累积生存率分别为86.5%、76.1%和69.8%。单因素分析显示血清乳酸脱氢酶水平(LDH)、B症状、病理类型及临床分期是影响预后的相关因素(P<0.05),多因素分析显示B症状、病理类型、临床分期是影响预后的独立因素(P<0.05)。结论 PGL临床表现缺乏特异性,B症状、病理类型、临床分期是影响预后的独立因素,在制定治疗方案及判断预后时应充分考虑上述因素。

Objective To analyze the clinical characteristics and prognosis of primary gastric lymphoma （PGL）. Methods We retrospectively analyzed the clinical and endoscopic characteristics, pathology and follow-up data of 58 PGL cases, and tried to define possible factors that influence the prognosis by univariate and multivariate analysis. Results Primary gastric lymphoma mostly Occurred in gastric antrum and gastric body. MALT lymphoma and DLBCL were the most common pathological subtypes. Overall cumulative survivals of 1, 3 and 5 years were 86.5%, 76.1% and 69.8% respectively. The nnivariate analysis showed that LDH level, B symptoms, pathological types and clinical stages were prognostic factors （P〈0.05）. Multivariate analysis indicated that B symptoms, pathological types and clinical stages were independent prognostic factors （P〈0.05）. Conclusion The clinical characteristics of PGL were non-specific. B symptoms, pathological types and clinical stages were independent prognostic factors, which was helpful to make treatments and evahiate prognosis.