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Primary gastric lymphoma. A clinicopathologic study of 233 cases with special reference to evaluation with the MIB‐1 index
Author(s) -
Nakamura Shotaro,
Akazawa Kouhei,
Yao Takashi,
Tsuneyoshi Masazumi
Publication year - 1995
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19951015)76:8<1313::aid-cncr2820760804>3.0.co;2-1
Subject(s) - medicine , lymphoma , primary (astronomy) , index (typography) , pathology , gastroenterology , oncology , world wide web , physics , astronomy , computer science
Background . Few articles have analyzed the prognostic data from a large series of primary gastric lymphoma classified according to the concept of mucosa‐associated lymphoid tissue (MALT). Methods . The resected specimens from 233 patients with primary gastric lymphoma were investigated retrospectively, including immunostaining with MIB‐1 (Ki‐67). Results . Histologically, 70 (30%) of the cases were low grade B‐cell lymphoma of MALT, 27 (12%) low grade B‐cell lymphoma of MALT with a focal high grade component, 100 (43%) high grade B‐cell lymphoma of MALT, 15 (6%) other B‐cell lymphomas, 14 (6%) T‐cell lymphomas, and 7 (3%) undetermined. Macroscopically, 96 (41%) were superficial‐spreading type, 100 (43%) mass‐forming, 14 (6%) diffuse‐infiltrating, and 23 (10%) unclassified. The MIB‐1 index correlated with phenotype, histologic grade, stage, depth of invasion, and macroscopic type. A significantly better survival was noted for young patients, and those with tumors of a B‐cell phenotype, histologic low grade, macroscopic superficial‐spreading type, low stage, low depth of invasion, and low MIB‐1 index. No significantly different survival rates were found between the patients who underwent gastric resection alone and those who also received additional chemotherapy. By Cox multivariate analysis, independent prognosticators included B‐cell phenotype, low stage, and macroscopic superficial‐spreading type. Conclusions . In addition to stage, phenotype and macroscopic type are also important prognostic indicators of primary gastric lymphoma. Immunostaining with MIB‐1 had limited independent value for predicting prognosis.