摘要
背景与目的:胃是淋巴瘤最为常见的节外侵犯部位。关于原发性胃恶性淋巴瘤(primarygastriclymphoma,PGL)治疗模式目前仍存在争议。本文分析PGL的临床特点,并探讨其治疗方式及预后因素。方法:68例PGL患者中,男性37例(54.4%),女性31例(45.6%),年龄25～82岁,中位年龄50岁。采用手术加化疗治疗37例,手术加化疗加放疗7例,手术加放疗9例,化疗加放疗9例,单纯手术4例,未治疗2例。运用SPSS10.0统计软件进行生存分析,采用Kaplan-Meier分析和log-rank检验进行单因素生存预后分析,多因素分析采用Cox模型。结果:PGL最常见的临床症状是上腹部疼痛、消瘦,发病部位以胃体、胃窦多见。本组68例均为非霍奇金淋巴瘤,占同期胃恶性肿瘤的3.4%。T细胞来源1例,其余均为B细胞来源。胃镜活检和X线钡餐诊断率分别是53.2%和40.9%。全组1、3、5年生存率分别为90.5%、78.2%和75.7%。单因素分析结果表明临床分期、国际预后指数(IPI)及手术对生存有影响,Cox多因素分析结果表明手术是独立的预后影响因素。结论:PGL治疗宜采用包括以手术、化疗和/或放疗为主的综合治疗。本组病例中手术是PGL独立的预后影响因素。
BACKGROUND &OBJECTIVES: Stomach is the most common extranodal in vo lvement site of lymphoma. Treatment patterns for primary gastric lymphoma (PGL) are controversial now. This study was to investigate clinical features, treatmen t patterns, and prognostic factors of patients with PGL. METHODS: Records of 68 patients with PGL,including 37(54.4%) men,and 31(45.6%) women with a median ag e of 50(25-82) years,were retrospectively analyzed. Thirty-seven patients rece ived surgery plus chemotherapy,7 received surgery plus chemoradiotherapy,9 recei ved surgery plus radiotherapy,9 received surgery plus chemotherapy,4 received su rgery alone,and 2 were untreated. Survival rate was calculated by Kaplan-Meier method,prognosis factors were analyzed by univariate analysis, and Cox model mul tivariate analysis. RESULTS: Common symptoms of PGL were abdominal pain, and wei ght loss. Common lesions of PGL were in gastric body, and gastric antrum. All 68 patients with PGL were diagnosed of non-Hodgkins lymphoma (NHL) by pathology , which constituted about 3.4%of all gastric malignancies synchronously, 1 was T cell original, 67 were B cell original. Diagnosis rate of gastroscopy biopsy w as 53.2%, that of X-ray barium meal was 40.9%. The overall 1-, 3-, and 5-y ear survival rates were 90.5%, 78.2%, and 75.7%, respectively. Univariate ana lysis showed that clinical stage (Ann Arbor), international prognostic index (IP I), and surgery were significant prognostic factors for PGL patients. Cox model multivariate analysis indicated that only surgery was independent prognostic fac tor for PGL patients. CONCLUSIONS: Treatment of PGL should be based on combined therapy of surgery, chemotherapy, and radiotherapy. Surgery may be an independen t prognostic factor for PGL patients.
出处
《癌症》
SCIE
CAS
CSCD
北大核心
2004年第12期1692-1695,共4页
Chinese Journal of Cancer
关键词
胃肿瘤
淋巴瘤
预后
Gastric neoplasms
Lymphoma
Prognosis
