Abstract:【Objective 】To analyze the clinical characteristics, survival and prognostic factors of primary gastric diffuse large B-cell lymphoma (PG-DLBCL). 【Methods】The clinical data of 41 patients with PG-DLBCL were retrospectively analyzed. we applied Kaplan-Meier to estimate the survival time of all patients. 【Results】 Among the 41 patients, the OS (overall survival) rate at 1- , 3- , and 5 years were 77.3%, 62.8%, 55.0%, respectively. Patients with surgery alone had very poor diagnosis. In PG-DLBCL patient with over 6 cycles of chemotherapy, there was no significant difference in the survival rate between chemotherapy alone and surgery combined chemotherapy (P>0.05). Patients with more than 6 cycles of chemotherapy had a significantly higher survival rate than patients under chemotherapy for 6 cycles(P<0.05). The prognosis of R-CHOP chemotherapy was better than CHOP. Univariate analysis showed that B-symptoms, Lugano stage ⅡE~Ⅳ, IPI (International Prognosis Index) score of 3-5 points, peripheral blood NLR ≥ 3.5, high CA125 , and LDH levels were predictors for poor prognosis in patients with PG-DLBCL(P<0.05). 【Conclusion】B symptoms, Lugano staging of ⅡE~Ⅳ, IPI score of 3~5 points, peripheral blood NLR≥3.5, increased CA125, and elevated LDH level were important influencing factors for poor prognosis of PG-DLBCL(P<0.05).Chemotherapy-based treatment program is recommended.Chemotherapy regimen of more than 6 cycles and chemotherapy with rituximab can improve the prognosis of patients.
黄凤祥, 刘畅, 吕桂阳, 莫钦丽, 马劼, 彭志刚. 原发性胃弥漫大B细胞淋巴瘤生存情况及预后影响因素分析[J]. 医学临床研究, 2018, 35(5): 853-855.
HUANG Feng-xiang, LIU Chang, LV Gui-yang, et al. Analysis of Survival and Prognostic Factors of Primary Gastric Diffuse Large B Cell Lymphoma. JOURNAL OF CLINICAL RESEARCH, 2018, 35(5): 853-855.
[1] Wang YG, Zhao LY, Liu CQ,et al. Clinical characteristics and prognostic factors of primary gastric lymphoma: A retrospective study with 165 cases[J].Med,2016, 95(31):e4250.
[2] Zhang J, Li G, Yang H, et al. Rituximab in treatment of primary gastric diffuse large B-cell lymphoma[J].Leukemia Lymphoma,2012, 53(11):2175-2181.
[3] 郑艳彬, 何鸿鸣, 杨瑜,等. 56例原发性胃弥漫大B细胞淋巴瘤患者的临床预后因素分析[J].癌症进展, 2015,12(5):545-549.
[4] Dawson IM, Cornes JS, Morson BC. Primary malignanty lymphoid tumours of the intestinal tract. Report of 37 cases with a study of factors influencing prognosis[ J] .Br J Surg,1961, 49( 1) :80-89.
[5] Hans CP, Weisenburger DD, Greiner TC, et al. Confirmation of the molecular classification of diffuse large B-cell lymphoma by immunohistochemistry of diffuse using a tissue microarray[J].Blood,2004, 103(1):275-282.
[6] Cheson B, Fisher R, Barrington S, et al. Recommendations for initial evaluation,staging and response assessment of Hodgkin and Non-Hodgkin Lymphoma- the Lungano classification[J].J Clin Oncol,2014, 32(27):3059-3067.
[7] Hung YS, Lin TL, Kuo MC, et al. Primary gastric diffuse large B-cell lymphoma[J].Chang Gung Medi J,2008, 31(2):159.
[8] Cheung MC, Housri N, Ogilive MP, et al. Surgery does not adversely affcet survival in primary gastrointestinal lymphoma [J].J Surg Oncol,2009, 100(1): 59-64.
[9] 石远凯, 孙燕, 刘彤华. 中国恶性淋巴瘤诊疗规范(2015年版)[J].中华肿瘤杂志, 2015, 37(2):148-151.
[10] Leopardo D, Di Lorenzo G, De Renzo A, et al. Efficacy of rituximab in gastricdiffuse large B cell lymphoma patients[J].World J Gastroenterol 2010;16(20):2526-2530.