Analysis of diagnosis and treatment of 40 patients with primary gastrointestinal diffuse large B-cell lymphoma / 中国医师进修杂志

ABSTRACT

Objective To study the clinical characteristics, treatment methods and prognosis of primary gastrointestinal diffuse large B-cell lymphoma (PGI-DLBCL). Methods The clinical data of 40 patients with PGI- DLBCL were retrospectively analyzed. All the cases had received surgery treatment. Results In 40 patients with PGI-DLBCL, the major clinical presentation included abdominal pain in 15 cases (37.5%), abdominal mass in 6 cases (15.0%), abdominal discomfort in 5 cases (12.5%), abdominal distension in 5 cases (12.5%), and hematemesis in 5 cases (12.5%). Fifteen cases were misdiagnosed as gastric cancer, 5 cases as colon cancer, and 4 cases as digestive tract ulcer. The misdiagnosis rate was 60.0% (24/40). The survival rates of 1- , 2- and 3- year were 62.3%, 57.5% and 52.6%. The univariate analyses result showed that the clinical stage, international prognosis index (IPI) and treatment method were associated with survival rate (P 0.05). The 3-year survival rate of clinical stage Ⅰ - Ⅱ was significantly higher than clinical stageⅢ-Ⅳ(68.0%vs. 13.3%), the 3-year survival rate of IPI 0-2 scores was significantly higher than 3 - 5 scores (66.7% vs. 7.6%), and the 3- year survival rate of surgery combined with postoperative chemotherapy was significantly higher than simple surgery (75.0%vs. 20.0%), there were statistical differences (P<0.01). Conclusions The patients with PGI- DLBCL have no obvious clinical manifestions and a higher misdiagnosed rate. Modified IPI, clinical stage and surgery combined with postoperative chemotherapy are the influencing factors of prognosis.