Analysis Of Clinical Prognostic Factors Of Primary Gastrointestinal Diffuse Large B-cell Lymphoma

Background and Objective Diffuse large B-cell lymphoma(DLBCL)is the most common histological subtype of non-Hodgkin’s lymphoma(NHL).It is also a highly heterogeneous and aggressive disease that seriously threatens the health and life of patients.In view of the particularity of the gastrointestinal anatomy and physiological functions,primary gastrointestinal diffuse large B-cell lymphoma(PGI-DLBCL)is considered to be a unique disease.Their diagnosis,evaluation,treatment and prognosis are different from those of diffuse large B-cell lymphoma in the lymph nodes.This article collects the case data of patients with PGI-DLBCL,explores the prognostic factors of PGI-DLBCL.Methods A total of 126 patients with PGI-DLBCL at the First Affiliated Hospital of Anhui Medical University and Anhui Provincial Hospital between July 2011 and August2019 were selected.The demographic data [gender,age],clinical characteristics(location of onset,pathological subtype,group B symptoms,Ann Arbor staging,NCCN-IPI score,mid-term efficacy evaluation,treatment methods)and laboratory characteristics(blood routine,biochemical,stool routine,immunohistochemistry)were collected for retrospective analysis.Kaplan-Meier survival analysis was used for univariate analysis,discovered factors related to the prognosis of primary gastrointestinal diffuse large B-cell lymphoma,Cox proportional hazard models were used for multivariate analysis to determine prognostic related factor.Results: Among 126 patients with PGI-DLBCL,65 males and 61 females,the average age were 54.78±14.34 years old,median age of onset 56 years.81 cases of primary stomach,38 cases of intestine,7 cases of gastrointestinal joint involvement.As of the follow-up date,the follow-up time were 3-108 months,and the median follow-up time were 28.5 months;116 were surviving at 1 year,53 were surviving at 3 years,and 25 were surviving at 5 years.1,3,5 year cumulative survival rates were 90.5%,87.0%,82.6%.22 patients died(17.5%),causes of death were disease changes.Age,Ann Arbor staging,NCCN IPI score,mid-term efficacy evaluation,lactate dehydrogenase(LDH),hemoglobin count(Hb),albumin(ALB),prealbumin,stool occult blood test,β2microglobulin,and lymphocyte percentage were allfactors associated with the poor prognosis of PGI-DLBCL.Hb,prealbumin,and mid-term efficacy evaluation were independent prognostic factors in patients with PGI-DLBCL.Conclusion Elderly(age> 60 years),Ann Arbor stage late,NCCN-IPI scores of highrisk,poor mid-term evaluation of the efficacy,LDH increased,anemia,hypoalbuminemia,low prealbumin anemia,positive fecal occult blood,high β2microglobulin and elevated lymphocyte percentage were associated with poor prognosis in PGI-DLBCL patients.Among them,anemia,low prealbumin and poor mid-term efficacy evaluation could be used as independent factors which affected the prognosis of PGI-DLBCL...