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目的探讨胃淋巴瘤的临床病理特点及预后相关因素。方法结合2001年版WHO关于淋巴造血组织肿瘤的分类标准,回顾83例胃淋巴瘤临床及病理资料,对其中78例进行随访,随访时间5～192个月。对临床病理特征及治疗方式等多种因素与生存率进行比较分析。结果(1)临床表现:临床症状以腹痛最多见,83例胃淋巴瘤中有60例(72%);39例(47%)有B症状(发热、盗汗、消瘦);21例(25%)有长期慢性胃病史;胃肠黏膜多部位病变13例(16%);淋巴结受累51例(61%)。(2)组织学类型:黏膜相关淋巴组织结外边缘区B细胞淋巴瘤(MALT淋巴瘤)为57例(69%),弥漫大B细胞淋巴瘤合并MALT淋巴瘤23例(28%),弥漫大B细胞淋巴瘤2例(2%),滤泡性淋巴瘤1例(1%)。(3)临床分期与生存率:临床ⅠE期31例,ⅡE期38例,ⅢE期8例,Ⅳ期6例。总5年和10年生存率分别为77.8%和70.1%,平均生存期146个月。MALT淋巴瘤的5、10年生存率分别为77.4%和72.3%,弥漫大B细胞淋巴瘤合并MALT淋巴瘤的5、10年生存率分别为81.8%和68.2%,弥漫大B细胞淋巴瘤的5年生存率为50.0%。结论胃淋巴瘤患者无特异临床症状。MALT淋巴瘤是最常见的病理组织学类型。胃淋巴瘤病变可长期局限,预后较好。患者生存率与淋巴结受累、临床分期密切相关,与发病年龄、性别、有无B症状、病变深度及范围和治疗方式等因素均不相关。
Objective To investigate the clinicopathological features and prognostic factors of gastric lymphoma. Methods According to the 2001 WHO classification of lymphoid hematopoietic tumors, the clinical and pathological data of 83 patients with gastric lymphoma were retrospectively reviewed. Among them, 78 patients were followed up for 5 to 192 months. The clinical and pathological features and treatment methods and other factors and survival rates were compared. Results (1) The clinical manifestations: the most common clinical symptoms of abdominal pain, 83 cases of gastric lymphoma in 60 cases (72%); 39 cases (47%) had symptoms of B (fever, night sweats, weight loss); 21 cases (25% ) Had a long history of chronic gastritis; 13 cases (16%) of lesions in multiple sites of gastrointestinal mucosa; 51 cases (61%) of lymph node involvement. (2) Histological type: Fifty-seven patients (69%) had mucosa-associated lymphoid tissue extranodal marginal zone B cell lymphoma (MALT lymphoma), 23 had diffuse large B cell lymphoma with MALT lymphoma (28%), Large B-cell lymphoma in 2 cases (2%), follicular lymphoma in 1 case (1%). (3) Clinical staging and survival rate: clinical stage Ⅰ E 31 cases, Ⅱ E 38 cases, Ⅲ E 8 cases, Ⅳ 6 cases. Overall 5-year and 10-year survival rates were 77.8% and 70.1%, respectively, with an average survival of 146 months. The 5-year and 10-year survival rates of MALT lymphoma were 77.4% and 72.3%, respectively. The 5-year and 10-year 5-year and 10-year survival rates of diffuse large B cell lymphoma with MALT lymphoma were 81.8% and 68.2%, respectively, with diffuse large B cell lymphoma 5-year survival rate was 50.0%. Conclusion There are no specific clinical symptoms in patients with gastric lymphoma. MALT lymphoma is the most common histopathological type. Stomach lymphoma lesions can be long-term limitations, the prognosis is good. The survival rate of patients with lymph node involvement, clinical stage is closely related to the age of onset, gender, with or without B symptoms, depth and extent of disease and treatment methods and other factors are not related.