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通过生存曲线及多因素分析 ,探讨原发性胃肠道淋巴瘤的临床特征与预后的关系。方法 :选择我院自1990年至1996年的原发性胃肠淋巴瘤共92例 ,均经病理确诊 ,并进行了含ADM为主方案多程化疗和/或手术切除治疗 ,同时有良好的随访。结果 :Kaplan Meier生存分析结果 ,2年的累积生存率为67 0 % ,5年的预计累积生存率为54 3 % ,平均生存期为54 8月 (95 %可信区间47 4～60 1月 ) ,5年无病生存率为63 1 %。按照AnArbor分期进行生存分析 ,5年总生存率及无病生存率分别为 :Ⅰ期均为85 7 % ,Ⅱ期63 4 %和54 8 % ,Ⅲ期19 4 %和22 2 % ,Ⅳ期13 9 %和5 6 % ,Log rank分析生存曲线有显著差异 (P=0 0001)。5年预计总生存期及无病生存期在PS状态、LDH酶、B症状、大肿物组病理类型这几个临床指标中均有显著差异。多因素分析5年预计总生存期与分期、病理类型、PS状态及LDH酶水平有关 ,无病生存期与分期及PS状态有关。结论 :胃肠道淋巴瘤的临床特征与其预后密切相关 ,目前常用的手术联合化疗治疗早期的胃肠道淋巴瘤取得较好的疗效 ,但手术治疗是否是必须的 ,尚需进一步进行对照研究
Through survival curve and multivariate analysis, the relationship between clinical characteristics and prognosis of primary gastrointestinal lymphoma was explored. METHODS: A total of 92 cases of primary gastrointestinal lymphoma in our hospital from 1990 to 1996 were selected and confirmed by pathology. ADM-based chemotherapy with multi-pass chemotherapy and/or surgical resection was performed. Follow-up. RESULTS: The Kaplan Meier survival analysis showed a 2-year cumulative survival rate of 67%, a predicted 5-year cumulative survival rate of 54.3%, and an average survival of 54 months (95% confidence interval, 474-160 months). ) The 5-year disease-free survival rate was 631%. According to the AnArbor staging analysis, the 5-year overall survival rate and disease-free survival rate were: 85.7% in phase I, 63.4% in phase II, and 548.8% in phase II, 194% and 22% in phase III, phase IV. 13 9 % and 56 %, Log rank analyzed the survival curves were significantly different (P = 0 0001). The 5-year predicted overall survival and disease-free survival were significantly different among PS, LDH enzyme, B symptoms, and pathological types of large tumor groups. Multivariate analysis The estimated 5-year overall survival was related to stage, pathological type, PS status, and LDH enzyme levels. Disease-free survival was related to stage and PS status. Conclusion : The clinical features of gastrointestinal lymphoma are closely related to its prognosis. Currently, the commonly used surgery combined with chemotherapy to achieve early treatment of gastrointestinal lymphoma has achieved better results, but whether surgical treatment is necessary, further studies need to be conducted.