Clinical Characteristics and Independent Risk Factors of Primary Gastrointestinal Lymphoma Complicated with Gastrointestinal Complications

Background: This study aimed to investigate the clinical characteristics and risk factors of primary gastrointestinal lymphoma (PGIL) in patients with gastrointestinal complications (GICs). Methods: A retrospective analysis was conducted on the clinical data of 148 patients with PGIL admitted to Yichang Central People's Hospital from January 2019 to August 2025. Univariable and multivariable logistic regression models were utilized to identify independent risk factors for GICs. Results: Patients with PGIL exhibited a high incidence (58.1%) of GICs, primarily bleeding, obstruction, and perforation. Bleeding predominantly involves gastric ulcerative lesions, whereas obstruction and perforation frequently affect the small intestine, with obstruction typically presenting endoscopically as protruding lesions. Compared to the non-GIC cohort, patients with GICs showed a significantly higher proportion of diffuse large B-cell lymphoma (DLBCL), poorer performance status (ECOG ≥ 2), and advanced tumor invasiveness. Furthermore, the GICs group demonstrated marked metabolic depletion, elevated systemic inflammation, significant bowel wall thickening, and lymphadenopathy. Crucially, multivariable analysis identified four independent risk factors for developing GICs: history of hypertension (odds ratio [OR] =3.724, CI: 1.149-12.074), primary intestinal site (OR=3.551, 95% CI: 1.240-10.170), deep lesion infiltration into the muscularis or serosa (OR=3.615, 95% CI: 1.132-11.546), and anemia (OR=4.288, 1.457-12.615). Conclusion: The high incidence of GICs in patients with PGIL is multifactorial. Early risk stratification and tailored interventions are crucial for patients presenting with hypertension, anemia, intestinal involvement, or deep tumor infiltration at the initial diagnosis to optimize therapeutic outcomes.