Diagnosis and treatment of 81 patients with primary gastrointestinal lymphoma.

Objective: To analyze the status quo of the diagnosis and treatments of primary gastrointestinal lymphoma (PGIL) in order to improve it.

Methods: Eighty-one patients with PGIL were analyzed retrospectively including clinical manifestations, endoscopic features, pathological features, HP infection, treatment, and prognosis.

Results: The age of patients with gastric lymphoma was (52.84+/-15.33) years. The age of patients with intestinal lymphoma was (42.09+/-15.28) years. Common symptoms included abdominal pain (76.5%), gastrointestinal bleeding (55.6%), anemia (54.3%), abdominal mass (25.9%), hypoproteinemia (40.7%), bowel obstruction (11.1%), abdominal distension, vomiting, and other non-specific gastrointestinal symptoms (32.1%), weight loss (33.3%); fever (8.6%), diarrhea (7.4%), digestive tract perforation (1.2%), constipation (1.2%), and dysphagia (1.2%). Endoscopic appearances were as follows: tumor type (67.7%), ulcer type (27.7%), and diffuse type (4.6%). Clinical diagnosis rate and endoscopic biopsy confirmation rate were 30.9% and 73.8%. MALT lymphoma accounted for 61.7% of the patients. HP detection rate was 39.5% and positive rate was 37.5%. A total of 69 patients received surgeries: 3 had preoperative chemotherapy, and 34 had postoperative chemotherapy. Twelve patients had non-surgical treatment, 6 patients of whom had simple chemotherapy and HP eradication therapy, and the other 6 gave up during the treatment. There was no significant difference in the survival rate of Stage I-II patients in the surgery alone group, surgery plus chemotherapy group, and chemotherapy and HP eradication therapy group(P>0.05). The survival rate of Stage III-IV patients in the surgery alone group was lower than that in the other 2 groups (P<0.05). The 5-year, 3-year, and 1-year survival rate was 55.87%, 70.96%, and 96.39%, respectively.

Conclusion: There are no specific clinical and endoscopic features in PGIL, so the misdiagnosis rate is high. Multi-site biopsy or repeated biopsies and immunohistochemical methods can be used to raise the pathological diagnosis rate. Chemotherapy and HP eradication are recommended.