原发性胃弥漫大B细胞淋巴瘤38例临床预后分析

doi:10.3877/cma.j.issn.1674-0793.2010.03.008

中华普通外科学文献(电子版) ›› 2010, Vol. 04 ›› Issue (03) : 216 -219. doi: 10.3877/cma.j.issn.1674-0793.2010.03.008

所属专题：经典病例；文献；

论著

原发性胃弥漫大B细胞淋巴瘤38例临床预后分析

张常华¹, 何裕隆¹^,^†(

), 陈创奇¹, 韩方海¹, 蔡世荣¹, 徐建波¹, 詹文华¹

^1. 510080　广州，中山大学附属第一医院胃肠胰外科，中山大学胃癌诊治研究中心

收稿日期:2009-12-28 出版日期:2010-06-01
通信作者: 何裕隆
基金资助:
国家自然科学基金项目(30700805); 广东省自然科学基金重点项目(07117381)

Clinical and prognostic analysis for 38 cases of primary gastric diffuse large B-cell lymphoma

Chang-hua ZHANG¹, Yu-long HE¹^,^†(), Chuang-qi CHEN¹, Fang-hai HAN¹, Shi-rong CAI¹, Jiang-bo XU¹, Wen-hua ZHAN¹

^1. Gastrointestinopancreatic Department of the First Affiliated Hospital and Gastric Cancer Center of Sun Yat-sen University, Guangzhou 510080, China

Received:2009-12-28 Published:2010-06-01
Corresponding author: Yu-long HE
About author:
Corresponding author: HE Yu-long, Email: zhchangh@mail.sysu.edu.cn

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目的

探讨原发性胃弥漫大B细胞淋巴瘤（PG-DLBL）的外科手术治疗的意义。

方法

回顾性分析我院1996年1月至2007年12月经胃镜活检或手术病理证实的38例PG-DLBL患者的临床病理资料，根据治疗情况分为手术联合化疗组与单纯化疗组，比较两组预后情况。

结果

手术联合化疗17例，单纯化疗21例。两组发病年龄、性别、肿瘤分期、肿瘤大小均无显著性差异，手术联合化疗组的5年生存率为56%，单纯化疗组为33%，差异无统计学意义（P=0.676）。单纯化疗组并发消化道出血1例。手术联合化疗组的完全缓解率为94.1%，单纯化疗组为81.0%（P=0.233）。

结论

手术不应是PG-DLBL的首选治疗措施。

关键词: 胃, 淋巴瘤, 大B细胞, 外科治疗, 预后

Objective

The treatment of gastric lymphoma continues to evolve, and the surgical resection of primary gastric lymphoma is debated. The aim of this study is to compare two strategies: surgical resection plus chemotherapy versus chemotherapy alone.

Methods

The records and data of 38 patients who had been diagnosed with primary gastric diffuse large B-cell lymphoma(PG-DLBL) between January 1996 and December 2007 in our hospital were investigated retrospectively. They were divided into two groups (surgical resection plus chemotherapy versus chemotherapy alone). Clinicopathological data and prognosis were compared between the two groups.

Results

Of these 38 patients, 17 patients underwent surgical resection plus chemotherapy and 21 were given chemotherapy alone. The chemotherapy regimens were CHOP and CHOP-like in both groups. There were no significant difference between the two groups about the onset age, sex, tumor stage and tumor mass. The 5-year survival of patients who underwent surgical resection plus chemotherapy was 56% and that of those who underwent chemotherapy alone was 33%. No significant differences were found in bivariate analysis between the two groups(P=0.676). Complete release rate was higher in the surgical resection plus chemotherapy group(94.1%) than the chemotherapy alone group(81.0%)(P=0.233).

Conclusion

Surgical resection should not be the first-choice treatment for patients with primary gastric diffuse large B-cell lymphoma.

Key words: Stomach, Lymphoma, Large B-cell, Surgical treatment, Prognosis

表1 两组患者临床病理及并发症的比较

?		手术联合化疗组	单纯化疗组	t或χ²值	P值
例数		17	21	?	?
性别[例(%)]		?	?	0.439	0.508
?	男	13(76.5)	14(66.7)	?	?
?	女	4(24.5)	7(33.3)	?	?
平均年龄(岁)		50.3±11.2	54.1±9.6	0.535	0.465
肿瘤最大径[cm(%)]		?	?	0.032	0.859
?	≤10	11(64.7)	13(61.9)	?	?
?	>10	6(35.3)	8(38.1%)	?	?
AnnArbor分期		?	?	0.0001	0.984
?	Ⅰ	4(23.5)	5(23.8)	?	?
?	Ⅱ	13(76.5)	16(76.2)	?	?

表1 两组患者临床病理及并发症的比较

?		手术联合化疗组	单纯化疗组	t或χ²值	P值
例数		17	21	?	?
性别[例(%)]		?	?	0.439	0.508
?	男	13(76.5)	14(66.7)	?	?
?	女	4(24.5)	7(33.3)	?	?
平均年龄(岁)		50.3±11.2	54.1±9.6	0.535	0.465
肿瘤最大径[cm(%)]		?	?	0.032	0.859
?	≤10	11(64.7)	13(61.9)	?	?
?	>10	6(35.3)	8(38.1%)	?	?
AnnArbor分期		?	?	0.0001	0.984
?	Ⅰ	4(23.5)	5(23.8)	?	?
?	Ⅱ	13(76.5)	16(76.2)	?	?

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Clinical and prognostic analysis for 38 cases of primary gastric diffuse large B-cell lymphoma

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Clinical and prognostic analysis for 38 cases of primary gastric diffuse large B-cell lymphoma