title: Diagnosis and treatment of 81 patients with primary gastrointestinal lymphoma.
abstract: 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.
  
  
  CONCLUSIONS
  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.
authors: Department of Digestion, Xiangya Hospital, Central South University, Changsha 410008, China. fengljz@sina.com
authors: Lijuan
authors: L
authors: Feng
authors: Guoping
authors: G
authors: Zhang
authors: Zhongliang
authors: Z
authors: Hu
authors: Yiyou
authors: Y
authors: Zou
authors: Fengying
authors: F
authors: Chen
authors: Guiying
authors: G
authors: Zhang
authors: Li'an
authors: L
authors: Tang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003131:Combined Modality Therapy; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy*; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult