| ObjectiveTo analyze the clinical characteristics and the factors related to the outcomes of primary intestinal lymphoma(PIL).MethodsCases with PIL in Fujian Medical University Union Hospital during the period January 2010 to December 2019 were collected and followed up.We retrospectively analyzed the clinical characteristics including gender,age,clinical symptoms,diagnosis method,predisposition site,tumor size,pathological classification,serum lactate dehydrogenase level,ECOG score,IPI score,clinical stage,treatment method and its impact on their survival rate through univariate and multivariate analysis.ResultsA total of 82 patients with PIL were included in this study,including 55 males and27 females,with a median age of 57 years.The most common symptom we observed was abdominal pain(64.6%),while the most common tumor location was small intestine(36.6%).All patients were non-Hodgkin’s lymphoma.Thirteen cases(15.9%)of PIL derived from T cells and 69 cases(84.1%)were derived from B cells,while the most common pathological subtype was diffuse large B cell lymphoma(DLBCL).Amid those cases,69 of their integrity data were available,and the 1-year,3-year,and 5-year cumulative overall survival(OS)rates were 71.0%,55.1%,and 31.9%,respectively.All the 82 cases carried with single tumors and were mostly seen at the small intestine followed by the ileocecal area.Post-staging analysis of patients based on the Lugano staging criteria for PIL revealed that the 5-year OS for stage I-II patients was 43.18%,and the 5-year OS for stage III-IV patients was 4.0%.B-cell lymphoma mainly resented as localized disease(Lugano stage I/II)while T-cell lymphomas involved multiple intestinal sites.Thus,T-cell lymphoma had more unfavourable characteristics such as advanced stage at diagnosis,and the 5-year overall survival(OS)rate was significantly lower than B-cell lymphoma(15.38% versus 32.14%,P< 0.005).Based on the IPI score,the 5-year OS decreased according to the low-risk group,low-medium-risk group,medium-high-risk group,and high-risk group decreased in turn.What’s more,Univariate analysis showed that the IPI score(P = 0.027),Lugano stage(P = 0.001),pathological type(P = 0.049),gender(P = 0.000)were correlated with the OS of PIL.Whereas,the Pathological type(P = 0.029),IPI score(P = 0.006),Lugano stage(P =0.000)and other factors are correlated with its PFS.However,there was no significant difference in Age,ECOG score,LDH,tumor location,presence or absence of B symptoms,method of diagnosis or treatment,and other factors in terms of the OS and PFS.Multivariate analysis showed that Lugano’s clinical stage was an independent factor related to the OS.ConclusionThe most common symptom of PIL is abdominal pain,and the tumor locations are most seen in the small intestine.And the most common pathological subtype is diffuse large B-cell lymphoma.As for there is no specific clinical manifestation when getting PIL,it’s difficult to make an early diagnosis.We observed that the gender,pathological type,IPI score,and Lugano stage are important factors related to the prognosis of patients with PIL.It indicates that Lugano clinical stage can be an independent factor affecting the prognosis of PIL.Also,the crux to achieve a better prognosis of PIL is to comprehensively evaluate its pathological types and clinical stages and select the most suitable treatment. |
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