Characteristics and prognosis of primary gastric diffuse large B-cell lymphoma
WANG Shixiong
LYU Yao
WANG Jianhong
DUAN Xiaohui
WU Zhentian
WANG Bingxuan
LIU Jing
JIA Weijing
FENG Juan
TANG Hailong
ZHANG Tao
GAO Guangxun
WANG Zhe
ZHANG Na
LIANG Rong
Abstract：Objective To conduct a retrospective cohort study on the clinical and pathological features of primary gastric diffuse large B-cell lymphoma(PG-DLBCL)to probe into the clinical factors which affect the efficacy and prognosis,especially inflammatory and nutritional indicators.Methods PG-DLBCL patients treated in Xijing Hospital,Air Force Medical University from January 2010 to January 2021 were included,and the effects of pathological and clinical features on progression-free survival time(PFS)and overall survival(OS)were analyzed.Kaplan-Meier survival curve was used for univariate survival analysis,and Cox proportional hazard model was used for multivariate survival analysis.Results A total of 84 PG-DLBCL patients were included in this study,whose median PFS was 39.5 months,5-year PFS rate was 59.6％,median OS was 48 months,and 10-year OS rate was 70.1％.Univariate survival analysis showed that the prognostic factors of PFS in PG-DLBCL patients included pathological classification,gross type,number of extra-lymph node lesions,Ann Arbor staging,Lugano staging,performance status(PS)score,international prognostic index(IPI)score,serum lactate dehydrogenase(LDH),β2-microglobulin(β2-MG),derived neutrophil/lymphocyte ratio(dNLR),systemic inflammatory response index(SIRI),β2 microglobulin/lymphocyte ratio(βLR),lactate dehydrogenase/lymphocyte ratio(LLR),and prognostic nutritional index(PNI).The prognostic factors of OS included gross type,number of extra-lymph node lesions,Lugano staging,Ann Arbor staging,PS score,IPI score,LDH,lymphocyte/monocyte ratio(LMR),SIRI,βLR,LLR,PNI and controlling nutritional status(CONUT)score.Multivariate survival analysis showed that the independent risk factors of PFS included Lugano staging,PS score,IPI score,elevated β2-MG and SIRI,while the independent risk factors of OS included Lugano stage,PS score,IPI score and SIRI.Conclusion Lugano staging can better predict the prognosis of PG-DLBCL patients,and chemotherapy should be the main treatment.dNLR,LMR,SIRI,PNI,βLR,LLR and CONUT score are simple and meaningful prognostic indicators of inflammation and nutrition in PG-DLBCL patients,among which SIRI has higher predictive value and may be a new prognostic indicator.
Keywords：diffuse large B-cell lymphomaprimary gastric lymphomainflammatory indexsystemic inflammatory response index
Publication Date：2023-12-28
Online Publishing Date：2026-08-26(First online date of this platform, not the publication date of the document)
Pages：6( 1219-1224 )