Clinical Diagnosis And Treatment Of Primary Gastric Diffuse Large B-cell Lymphoma

Objective Investigate the clinical characteristics and prognostic factors of primary gastric diffuse large B-cell lymphoma(DLBCL),and provide reference for standardized diagnosis and treatment of primary gastric DLBCL.MaterialsA total of 61 patients with primary gastric DLBCL admitted to the First Affiliated Hospital of Anhui Medical University from January 2013 to January 2018 were collected.All patients were diagnosed by pathology.The gender,age of diagnosis,clinical manifestations and postoperative pathology were analyzed.The follow-up data were obtained through outpatient review,telephone follow-up and letter survey,and analyzed by statistical software.ResultsIn this study,a total of 61 patients were included,with a median age of 62 years(37-78years).The male to female ratio was male(36 cases): female(25 cases): 1.44:1.The main clinical manifestations were abdominal distension(47 cases,77.0%),abdominal pain(42 cases,68.9%),anorexia(13 cases,21.3%),haematemesis(5 cases,8.2%)and melena(4 cases,6.6%).The commonly used auxiliary examinations included ultrasonic gastroscopy,digestive endoscopy,CT and X-ray contrast examination.The positive diagnosis rates respectively were 100%(4 / 4),72.1%(44 / 61),24.6%(15 / 61)and15.0%(3 / 20).Immunohistochemistry showed that the positive index of Ki-67 was40%-90%,31 cases were more than 50%,and the positive expression rate of Bcl-2 was52.5%.The average diameter of primary tumor was 7.26 cm in 61 patients,including 15 cases of < 5cm and 46 cases of ≥ 5cm.There were 23 cases with mucosal infiltration,16 cases with muscularis and 22 cases with whole or extraserous invasion.A total of 39 cases were diagnosed as stage IE + IIE,22 cases were diagnosed as stage IIIE + IVE.The average survival time of 61 patients with primary gastric DLBCL was(55.65 ± 2.753)months,and the median survival time was(63.00 ± 0.879)months.The 1-year,2-year and 3-year survival rates were respectively 86.4%,82.0% and 65.4%.The age,clinical stage and albumin level of patients affected the prognosis(P < 0.05),and albumin level was an independent prognostic factor(P < 0.05).ConclusionPrimary gastric DLBCL is a special type of gastric malignancy with low incidence rate,but the incidence rate and the rate of diagnosis are increasing year by year.It is common in elderly men.There is no specific clinical manifestation.Primary gastric DLBCL is a heterogeneous disease.Different subtyes can cause different clinical manifestations and therapeutic effects.The age,clinical stage and albumin level affect the primary gastric DLBCL patients.Albumin level is an independent prognostic factor in patients with primary gastric DLBCL.