目的：探讨原发性胃弥漫大B细胞淋巴瘤（primary gastric diffuse large B-cell lymphoma，PG-DLBCL）的预后影响因素。方法回顾性分析56例PG-DLBCL患者的临床资料及随访数据，采用Kaplan-Meier法估算患者的生存时间，采用Cox比例风险模型进行预后影响因素分析。结果56例PG-DLBCL患者的1年、2年、3年无事件生存率分别为73.2%，71.3%，68.8%，平均无事件生存时间（event-free survival，EFS）为69个月；1年、2年、3年总生存率分别为81.8%，73.3%，70.5%，平均总生存时间（overall survival，OS）为72个月。化疗联合放疗组的平均EFS比单纯化疗组长，差异有统计学意义（P﹦0.039）；不同的Musshoff分期、LDH水平、淋巴瘤国际预后指数（international prognostic index，IPI）评分、β2微球蛋白值、美国东部肿瘤协作组（Eastern Cooperative On-cology Group，ECOG）体能状态（performance status，PS）评分、有无巨块对EFS及OS均有明确的影响（P＜0.05）。影响EFS及OS的独立预后因素为LDH水平及ECOG评分。结论对PG-DLBCL患者推荐采取以化疗为主的非手术治疗，LDH升高及PS评分高是预后不良的重要指标。%Objective To analyze the prognosis of primary gastric diffuse large B-cell lymphoma (PG-DLBCL). Method The clinical profiles and follow-up datas of 56 patients with PG-DLBCL were retrospectively analyzed. Ka-plan-Meier was applied to estimate the survival time of all patients, while Cox proportional hazard model was used to investigate the association between clinicopathological features with prognosis. Result The EFS (event-free survival) rate at 1-, 2-, and 3 years were 73.2%, 71.3%, and 68.8%, respectively, with a mean EFS of 69 months. The OS (overall survival) rate at 1-, 2-, and 3 years were 81.8%, 73.3%, and 70.5%, respectively, with a mean OS of 72 months. Therefore the mean EFS of chemotherapy + radiotherapy group is significantly longer than that of the radio-therapy alone group (P =0.039). Univariate analysis revealed that either EFS or OS was significantly influenced by Musshoff stage, LDH level, international prognostic index score, β2 microglobulin value, ECOG PS score, presence of giant mass (P<0.05). Cox regression model revealed that only LDH level and ECOG score were independent prognos-tic factors for EFS and OS. Conclusion Non-surgical treatment, as chemotherapy, is recommended for PG-DLBCL patients. LDH level and PS score are independent prognostic factors for PG-DLBCL.
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