The risk of digestive tract complications in patients with gastrointestinal lymphoma: A propensity score study

The risk of digestive tract complications in patients with gastrointestinal lymphoma: A propensity score study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article The risk of digestive tract complications in patients with gastrointestinal lymphoma: A propensity score study Yahan Zhao, Xuchen Zhang, Yuanzhi Zhou, Dai Nan, Yarui Li, Shuixiang He This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7621218/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 03 Mar, 2026 Read the published version in BMC Gastroenterology → Version 1 posted 11 You are reading this latest preprint version Abstract Background This study assessed the clinical characteristics of gastrointestinal bleeding (GIB), obstruction (GIO), and perforation (GIP) in patients with primary gastrointestinal lymphomas. Methods A retrospective analysis was performed of 347 patients with primary gastrointestinal lymphomas admitted to the First Affiliated Hospital of Xi’an Jiaotong University Between January 2014 and January 2024. The clinical characteristics of GIB, GIO, and GIP were recorded. This study employed propensity score matching (PSM) to identify risk factors for gastrointestinal complications (GICs). Results In our study of primary gastrointestinal lymphoma cohort, GICs occurred in 34.0% of patients. In our study, GIB occurred in 75 cases (21.6%), GIO occurred in 45 cases (12.9%) and GIP occurred in 28 cases (8.0%). PSM analysis indicated that decreased hemoglobin (112.57 ± 19.95 vs. 100.24 ± 23.20, P = 0.041) and LDH (272.00, 189.00-399.00 vs. 188.00, 166.00-230.90, P = 0.011) levels, as well as the presence of stomachache (P = 0.027) are high-risk factors for the development of GIB. Stomachache (28 [62.2%] vs. 37 [82.2%], P = 0.034), vomiting (12 [26.7%] vs. 21 [46.6%], P = 0.031), and endoscopic evidence of hyperplastic lesions (P = 0.022) are identified as high-risk factors for GIO. Moreover, patients with endoscopic findings of ulcerative lesions (4 [14.2%] vs. 12 [42.9%]), decreased hemoglobin levels (119.5 ± 22.32 vs. 102.79 ± 25.50, P = 0.012), stomachache (16 [57.1%] vs. 23 [82.1%], P = 0.048), and constipation (8 [28.6%] vs. 3 [10.7%], P = 0.043) are more likely to experience GIP. Conclusion This study attempted to identify risk factors for GIB, GIO, and GIP in patients with primary gastrointestinal lymphoma through PSM analysis. primary gastrointestinal lymphomas propensity score matching gastrointestinal complication gastrointestinal bleeding gastrointestinal obstruction gastrointestinal perforation 1. Introduction Primary extranodal lymphoma is defined as a type of lymphoma that originates in tissues and organs other than the lymph nodes, rather than primarily involving the lymph nodes.[ 1 ] The digestive system, particularly the gastrointestinal tract, is rich in lymphatic tissue, making it a common site for lymphoma invasion. Primary gastrointestinal lymphomas, although less frequent than epithelial cancers, still account for approximately 1% of all gastrointestinal tumors. Among these, the stomach is the most frequently affected organ, followed by the small and large intestines. In contrast, involvement of the esophagus, appendix, and rectum is relatively rare.[ 2 ] Primary gastrointestinal lymphoma can be categorized into B-cell lymphoma and natural killer (NK)/T-cell lymphoma. Additionally, based on the disease course, it is divided into aggressive and indolent types. Indolent B-cell lymphomas, such as mucosa-associated lymphoid tissue (MALT) lymphoma and follicular lymphoma (FL), typically cause minimal invasive damage to the gastrointestinal tract.[ 3 ] Primary gastrointestinal T/NK cell lymphomas (PGI-TNKL) are aggressive malignancies that encompass a variety of subtypes, each characterized by distinct clinicopathological features and prognoses.[ 4 ] Aggressive gastrointestinal lymphomas exhibit more invasive growth patterns and carry a worse prognosis compared to their indolent counterparts. When aggressive lymphomas occur in the gastrointestinal tract, severe gastrointestinal complications (GICs) such as gastrointestinal bleeding (GIB), gastrointestinal obstruction (GIO), and gastrointestinal perforation (GIP) are also common at the time of initial presentation. These complications are particularly prevalent after chemotherapy. Notably, GIP can lead to a very high mortality rate.[ 5 ] Timely identification of risk factors for GICs may facilitate early intervention and improve the prognosis for patients with aggressive gastrointestinal lymphoma. In a retrospective analysis of 148 patients, 56.8% experienced GICs, encompassing GIB, GIO, GIP, and multiple complications.[ 6 ] Patients with gastrointestinal lymphoma who develop GICs, such as GIB, GIO and GIP, and others, experience a significant decline in quality of life and may face severe clinical consequences, including life-threatening situations.[ 7 ] The occurrence of these complications was related to the aggressiveness of the tumor and the complexity of the treatment, and may indicated disease progression.[ 8 ] Therefore, early identification and active treatment of these complications are crucial for improving patients’ prognosis. However, there was no systematic summary of the risks of GICs in primary gastrointestinal lymphoma in current studies. Accurately identifying high-risk patients for GICs among primary gastrointestinal lymphoma patients was crucial for improving treatment outcomes and overall survival. In this study, we attempted to systematically analyze diagnosed with primary gastrointestinal lymphoma at our medical center in the past. We compared various indicators between the GICs group and the No-GICs group, identified risk factors for predicting GICs, which is conducive to the early identification of GICs by clinicians and attempts to provide evidence-based support for treatment. 2. Materials and Methods Patient Selection and evaluation criterion The patients included inpatient and outpatient lymphoma patients at our hospital from January 2014 and January 2024, and followed up until January 2025. Follow-up methods included in-patient review, outpatient review, and telephone follow-up. Primary gastrointestinal lymphoma was defined as predominant lesions in the alimentary tract with or without regional lymph node involvement.[ 9 ] All cases were diagnosed according to the World Health Organization diagnostic criteria.[ 1 ] All patients underwent gastroscopy and colonoscopy. The exclusion criteria were as follows: age under 18 years, infection with human immunodeficiency virus (HIV), lack of informed consent, inconsistent pathological diagnosis, or inability to undergo gastroscopy and colonoscopy. The clinical data of all patients at the time of initial diagnosis were collected in our cancer center, including age, gender, BMI, disease stage, blood lactate dehydrogenase (LDH), albumin, hemoglobin, symptoms, treatment methods and endoscopy or endoscopic ultrasonography. This retrospective research was approved by The Medical Research Ethics Committee of The First Affiliated Hospital of Xi’an Jiaotong University and conducted in accordance with the declaration of Helsinki. Macroscopy/endoscopy The macroscopic characteristics of lesions, including their morphology and size, were meticulously reviewed by a panel of expert endoscopists and pathologists. These assessments were based on detailed endoscopic observations and/or histopathological examination of specimens obtained from surgical resection. The lesion morphology was classified into four distinct categories: ulcerative, exophytic, hyperplastic, and punctate hemorrhage. Evaluation outcome criteria GICs were confirmed by clinical symptoms, laboratory tests, imaging, and/or surgery. GIO, including partial and complete obstruction, was considered to be the absence of passage of flatus or feces.[ 10 ] GIP was defined as the presence of free air under the diaphragm on abdominal imaging, or intestinal perforation during laparotomy.[ 11 ] GIB was defined as overt bleeding (hematemesis, bloody stools) and drop in hemoglobin of ≥ 2 g/dL.[ 12 ] All the above GICs were confirmed using imaging or surgery. During the course of the disease, it was possible to develop two or more complications. Statistical analysis The statistical analysis of the data was conducted using SPSS 26.0 (IBM Corp, Armonk, NY, USA). To ensure comparability between groups, propensity score matching (PSM) was utilized to perform 1:1 matching with a tolerance level of 0.02. The variables incorporated into the matching process included age, body mass index (BMI), sex, type of operative treatment, and disease stage. To evaluate the distribution of continuous variables within the sample, the Kolmogorov-Smirnov test was employed. Quantitative data that adhered to a normal distribution were reported as mean ± standard deviation (SD), while those exhibiting a non-normal distribution were described using the interquartile range (IQR). Categorical data were presented as frequency and proportion. For statistical comparisons, normally distributed quantitative data were analyzed using the independent samples t-test. In contrast, non-normally distributed data were assessed using the nonparametric Wilcoxon rank-sum test. Categorical data were examined using the chi-square test, Fisher’s exact test, or rank-sum test, as appropriate for the specific analysis. 3. Results GIB This study included a total of 347 patients. Before (PSM), there were 272 patients in the non-GIB group and 75 patients in the GIB group. After PSM, both the non-GIB and GIB groups had 75 patients each. Before PSM, the mean age of patients in the non-GIB group was 57.03±14.33 years, and in the GIB group, it was 57.45±16.02 years. After PSM, the mean age of patients in the non-GIB group was 58.08±15.55 years, and in the GIB group, it remained 57.45±16.02 years. The P-values for age differences between the two groups were not statistically significant both before and after PSM. Before PSM, the non-GIB group had 143 males (52.6%), and the GIB group had 42 males (56.0%). After PSM, the non-GIB group had 41 males (54.7%), and the GIB group had 42 males (56.0%). Before PSM, there was a significant statistical difference in the number of patients who underwent surgical treatment between the two groups (P=0.004). After PSM, all baseline indicators between the two groups were not statistically significant (P>0.05).(shown in Table 1.) Table 1. Comparison of the clinical baseline data between the two groups for GIB Before PSM t/x 2 /z P After PSM t/x 2 /z P Non-GIB group GIB group Non-GIB group GIB group n 272 75 n 75 75 Age(years) 57.03±14.33 57.45±16.02 -0.223 0.824 Age(years) 58.08±15.55 57.45±16.02 0.243 0.808 BMI(kg/m 2 ) 24.71±3.33 23.84±4.41 0.661 0.511 BMI(kg/m2) 24.42±3.2 23.81±4.51 0.651 0.515 Male(%) 143(52.6) 42(56.0) 0.277 0.598 Male(%) 41(54.7) 42(56.0) 0.027 0.870 Operative treatment(%) 229(84.2) 52(69.3) 8.426 0.004 Operative treatment(%) 63(84.0) 52(69.3) 4.509 0.034 Stage(%) 1.135 0.769 Stage(%) 1.924 0.588 I 53(19.5) 17(22.7) I 11(14.7) 17(22.7) II 52(19.1) 17(22.7) II 17(22.7) 17(22.7) III 51(18.8) 12(16.0) III 16(21.3) 12(16.0) IV 116(42.6) 29(38.7) IV 31(41.3) 29(38.7) After propensity score matching (PSM), there were 75 patients in both the non-GIB and GIB groups (matched at a 1:1 ratio). Among all the indicators included in this study, hemoglobin levels showed a significant difference between the two groups (112.57±19.95 vs. 100.24±23.20, P=0.041); LDH levels also showed a significant difference (272.00, 189.00-399.00 vs. 188.00, 166.00-230.90, P=0.011). Regarding abdominal symptoms, abdominal pain was significantly different between the two groups (P=0.027).(shown in Table 2.) Table 2. Comparison of the clinical variables for between the two groups of patients after propensity score matching Evaluation indicators Non-GIB group(n=75) GIB group(n=75) t/x 2 /z P ALB(g/L) 34.60±6.29 36.32±6.14 -1.692 0.093 HGB(g/L) 112.57±19.95 100.24±23.20 -3.189 0.041 LDH(U/L) 272.00(189.00, 399.00) 188.00(166.00, 230.90) -4.150 0.011 PA(mg/dl) 175.40(116.50, 221.10) 177.00(115.30, 206.20) -0.566 0.572 IPI class(%) 5.679 0.339 0 9(12.0) 8(10.7) 1 10(13.3) 18(24.0) 2 23(30.7) 28(37.3) 3 17(22.7) 12(16.0) 4 12(16.0) 7(9.3) 5 4(5.3) 2(2.7) Symptoms(%) 36(48) 40(53.3) 0.427 0.514 Stomachache(%) 14(18.7) 26(34.7) 4.909 0.027 Vomiting(%) 22(29.3) 19(25.3) 0.302 0.583 Constipation(%) 25(33.3) 30(40) 2.117 0.311 Endoscope types(%) 1.847 0.605 Ulcerative type 25(33.3) 32(42.7) Exogenous type 25(33.3) 20(26.7) Hyperplastic type 13(17.3) 10(13.3) Punctate hemorrhage 12(16) 13(17.3) Note: ALB, Albumin; HGB, hemoglobin; LDH, blood lactate dehydrogenase; PA, Prealbumin; IPI, International Prognostic Index GIO Before PSM, there were 302 patients in the non-GIO group and 45 patients in the GIO group. After PSM, both the non-GIO and GIO groups had 45 patients each. Before PSM, the mean age of patients in the non-GIO group was 57.12±14.43 years, and in the GIO group, it was 56.40±17.13 years. After PSM, the mean age of patients in the non-GIO group was 55.00±16.74 years, and in the GIO group, it remained 56.40±17.13 years. The P-values for age differences between the two groups were not statistically significant both before and after PSM. Before PSM, there was a significant statistical difference in the number of patients who underwent surgical treatment between the two groups (P=0.001). After PSM, all baseline indicators between the two groups were not statistically significant (P>0.05).(shown in Table 3.) Table 3. Comparison of the clinical baseline data between the two groups for GIB Before PSM t/x 2 /z P After PSM t/x 2 /z P Non-GIO group GIO group Non-GIO group GIO group n 302 45 n 45 45 Age(years) 57.12±14.43 56.40±17.13 0.305 0.760 Age(years) 55.00±16.74 56.40±17.13 -0.392 0.696 BMI(kg/m 2 ) 24.52±3.12 23.62±4.22 0.787 0.497 BMI(kg/m2) 24.25±3.05 23.62±4.22 0.688 0.534 Male(%) 158(52.3) 26(57.8) 0.469 0.494 Male(%) 25(55.6) 26(57.8) 0.045 0.832 Operative treatment(%) 75(24.8) 25(55.6) 18.019 0.001 Operative treatment(%) 15(33.3) 25(55.6) 4.500 0.064 Stage(%) 5.386 0.146 Stage(%) 2.203 0.532 I 61(20.2) 10(22.2) I 8(17.8) 10(22.2) II 50(16.6) 13(28.9) II 9(20) 13(28.9) III 62(20.5) 5(11.1) III 9(20) 5(11.1) IV 129(42.7) 17(37.8) IV 19(42.2) 17(37.8) After PSM, both the GIO and non-GIO groups had 45 patients each. Among all the indicators included, there were significant differences between the two groups in stomachache (28 [62.2%] vs. 37 [82.2%], P=0.034) and vomiting (12 [26.7%] vs. 21 [46.6%], P=0.031). There was also a significant difference in the type of endoscopy between the two groups (P=0.022). Notably, hyperplastic lesions were significantly more common in the GIO group than in the non-GIO group.(shown in Table 4.) Table 4. Comparison of the clinical variables for between the two groups of patients after propensity score matching Evaluation indicators Non-GIO group(n=45) GIO group(n=45) t/x 2 /z P ALB(g/L) 35.12±6.27 32.83±6.41 1.712 0.090 HGB(g/L) 108.49±25.37 108.29±23.37 0.039 0.969 LDH(U/L) 210.00(169.50, 339.00) 208.00(167.00, 316.00) -0.529 0.597 PA(mg/dl) 193.30(122.10, 217.30) 140.80(91.45, 208.35) -1.537 0.124 IPI class(%) 3.923 0.561 0 6(13.3) 5(11.1) 1 13(28.9) 15(33.3) 2 10(22.2) 7(15.6) 3 14(31.1) 11(24.4) 4 1(2.2) 3(6.7) 5 1(2.2) 4(8.9) Symptoms(%) 21(46.7) 26(57.8) 1.113 0.291 Stomachache(%) 28(62.2) 37(82.2) 4.486 0.034 Vomiting(%) 12(26.7) 21(46.6) 4.216 0.031 Constipation(%) 16(35.6) 14(31.1) 0.200 0.655 Endoscope types(%) 5.343 0.022 Ulcerative type 16(35.6) 10(22.2) Exogenous type 15(33.3) 10(22.2) Hyperplastic type 7(15.6) 21(46.6) Punctate hemorrhage 7(15.6) 4(8.9) Note: ALB, Albumin; HGB, hemoglobin; LDH, blood lactate dehydrogenase; PA, Prealbumin; IPI, International Prognostic Index GIP For the complication of GIP, before PSM, there were 319 patients in the non-GIP group and 28 patients in the GIP group. After PSM, both groups had 28 patients each. After PSM, there were no significant differences in all baseline indicators between the two groups (P > 0.05). The age of patients in the non-GIP group was 55.14±18.45, and in the GIP group, it was 55.07±18.61. The proportion of males was 16 (57.1%) in the non-GIP group and also 16 (57.1%) in the GIP group. Among the non-GIP group, 11 (39.3%) patients underwent surgical treatment, while in the GIP group, 7 (25.0%) patients underwent surgical treatment.(shown in Table 5.) Table 5. Comparison of the clinical baseline data between the two groups for GIP Before PSM t/x 2 /z P After PSM t/x 2 /z P Non-GIP group GIP group Non-GIP group GIP group n 319 28 n 28 28 Age(years) 57.10±14.43 55.07±18.61 0.695 0.487 Age(years) 55.14±18.45 55.07±18.61 0.014 0.989 BMI(kg/m 2 ) 24.96±3.32 24.22±4.11 0.811 0.507 BMI(kg/m2) 24.22±3.11 24.22±4.11 0.667 0.431 Male(%) 168(52.7) 16(57.1) 0.207 0.649 Male(%) 16(57.1) 16(57.1) 0.001 1.000 Operative treatment(%) 93(29.2) 7(25.0) 0.216 0.642 Operative treatment(%) 11(39.3) 7(25.0) 1.310 0.252 Stage(%) 8.966 0.030 Stage(%) 5.493 0.139 I 67(21.0) 3(10.7) I 3(10.7) 3(10.7) II 55(17.2) 8(28.6) II 7(25.0) 8(28.6) III 68(21.3) 1(3.6) III 7(25.0) 1(3.6) IV 129(40.4) 16(57.1) IV 11(39.3) 16(57.1) For GIP, after propensity score matching (PSM), there was a significant difference in hemoglobin levels between the two groups (119.5±22.32 vs. 102.79±25.50, P=0.012). Similarly, there were significant differences between the groups in terms of stomachache (16 [57.1%] vs. 23 [82.1%], P=0.048) and constipation (8 [28.6%] vs. 3 [10.7%], P=0.043). Regarding endoscope types, there was a significant difference in the prevalence of ulcerative lesions between the groups (4 [14.2%] vs. 12 [42.9%]). (shown in Table 6.) Table 6. Comparison of the clinical variables for between the two groups of patients after propensity score matching Evaluation indicators Non-GIB group(n=75) GIB group(n=75) t/x 2 /z P ALB(g/L) 34.60±6.29 36.32±6.14 -1.692 0.093 HGB(g/L) 112.57±19.95 100.24±23.20 -3.189 0.041 LDH(U/L) 272.00(189.00, 399.00) 188.00(166.00, 230.90) -4.150 0.011 PA(mg/dl) 175.40(116.50, 221.10) 177.00(115.30, 206.20) -0.566 0.572 IPI class(%) 5.679 0.339 0 9(12.0) 8(10.7) 1 10(13.3) 18(24.0) 2 23(30.7) 28(37.3) 3 17(22.7) 12(16.0) 4 12(16.0) 7(9.3) 5 4(5.3) 2(2.7) Symptoms(%) 36(48) 40(53.3) 0.427 0.514 Stomachache(%) 14(18.7) 26(34.7) 4.909 0.027 Vomiting(%) 22(29.3) 19(25.3) 0.302 0.583 Constipation(%) 25(33.3) 30(40) 2.117 0.311 Endoscope types(%) 1.847 0.605 Ulcerative type 25(33.3) 32(42.7) Exogenous type 25(33.3) 20(26.7) Hyperplastic type 13(17.3) 10(13.3) Punctate hemorrhage 12(16) 13(17.3) Note: ALB, Albumin; HGB, hemoglobin; LDH, blood lactate dehydrogenase; PA, Prealbumin; IPI, International Prognostic Index 4. Discussion Primary gastrointestinal lymphoma has the potential to arise in any segment of the digestive tract. It is most frequently encountered in the stomach, with the small intestine being the next common site, followed by the colon and rectum. In contrast, its occurrence in the esophagus is relatively rare.[ 13 ] Owning to the rapid progression of the primary gastrointestinal lymphoma, the enlargement and invasive characteristics of the mass were easy to cause GICs, the management of GICs remained a clinical challenge.[ 11 ] GICs were life-threatening acute abdomens such as GIO, GIP, and GIB. In particular, the perforation rate of small intestine was more than 50%, and the mortality rate was high.[ 14 ] In our study of primary gastrointestinal lymphoma cohort, GICs occurred in 34.0% of patients. In our study, GIB occurred in 75 cases (21.6%), GIO occurred in 45 cases (12.9%) and GIP occurred in 28 cases (8.0%). PSM analysis indicated that decreased hemoglobin and LDH levels, as well as the presence of stomachache, are high-risk factors for the development of GIB. Stomachache, vomiting, and endoscopic evidence of hyperplastic lesions are identified as high-risk factors for GIO. Moreover, patients with endoscopic findings of ulcerative lesions, decreased hemoglobin levels, stomachache, and constipation are more likely to experience GIP. Stomachache serves as a crucial warning sign in patients with primary gastrointestinal lymphoma, potentially signaling the emergence of severe complications such as bleeding, perforation, or obstruction. Timely identification and intervention are vital for enhancing patient outcomes.[ 15 ] This is mainly related to the growth pattern, location of the tumor and its impact on the surrounding tissues.[ 16 ] Tumor growth may induce the formation of mucosal ulcers, which can subsequently lead to bleeding or perforation. Concurrently, the mechanical compression exerted by the tumor can cause narrowing of the gastrointestinal lumen, resulting in obstruction.[ 17 ] The growth patterns of these tumors can lead to acute abdomen syndromes, which are primarily characterized by abdominal pain, such as obstruction, perforation, bleeding, and intussusception. Moreover, certain highly aggressive lymphoma types and the side effects of chemotherapy may further increase the risk of these complications.[ 18 ] Thus, in these patients, abdominal pain serves as a vital warning signal that may herald the onset of severe complications. Timely identification and treatment are of utmost importance for improving patient outcomes. Primary gastrointestinal lymphoma often manifests as submucosal tumors. As the tumor grows, it can lead to the formation of mucosal ulcers, which in turn can cause bleeding.[ 19 ] This bleeding may present as hematemesis, melena, or hematochezia, resulting in a decrease in hemoglobin levels.[ 20 ] Further development of the ulcers may perforate the gastrointestinal wall, leading to perforation. Perforation can cause peritonitis, characterized by severe abdominal pain, fever, and abdominal muscle rigidity, and in severe cases, may lead to sepsis and shock. Perforation can also cause internal bleeding, further reducing hemoglobin levels.[ 21 ] Chemotherapy or the natural progression of the tumor may lead to tumor necrosis.[ 22 ] Necrotic tissue releases LDH into the bloodstream, causing an increase in LDH levels.[ 23 ] Along with tumor progression and necrosis, the risk of gastrointestinal bleeding and perforation also increases. Therefore, changes in hemoglobin and LDH levels are important clinical indicators that can help doctors to identify severe complications such as bleeding and perforation at an early stage. Timely diagnosis and treatment are crucial for improving patients' prognosis. Ulcers have the potential to erode blood vessels within the gastrointestinal wall, thereby triggering acute bleeding. This form of bleeding may present as hematemesis, which is the vomiting of blood, melena characterized by black, tarry stools, or hematochezia indicated by bright red blood in the stool. In particularly severe instances, it can progress to hemorrhagic shock.[ 24 ] The risk of blood vessel erosion increases with the depth and extent of the ulcers. When ulcers are larger, they are more likely to penetrate multiple layers of the gastrointestinal wall, thereby heightening the probability of bleeding.[ 25 ] Primary gastrointestinal lymphoma exhibits a certain degree of invasiveness, with tumor cells potentially invading blood vessels directly, thereby causing bleeding. Petechial bleeding typically signifies that the gastrointestinal mucosa has already sustained damage and that the tissue has become fragile. This increased fragility elevates the risk of gastrointestinal wall perforation.[ 26 ] Petechial bleeding may be associated with local inflammation and tissue necrosis. Necrotic tissue is more prone to rupture, which can lead to perforation. Chemotherapy can induce tumor cell necrosis and shedding, causing further damage to the gastrointestinal mucosa and thereby increasing the risk of perforation. [ 27 ] The detection of ulcers and petechial bleeding during endoscopy is an important warning sign, indicating that patients may be at risk of bleeding and perforation. Early identification of these risks and the implementation of appropriate interventions are crucial for improving patients' prognosis. This study is a limited-scale, single-center retrospective investigation with a relatively small sample size. Given these limitations, it is essential to conduct large-scale prospective trials to identify appropriate predictors for GIB, GIO and GIP. There is a wide array of chemotherapy regimens available for primary gastrointestinal lymphoma, and these treatments often induce a variety of gastrointestinal complications, including bleeding, obstruction, and vomiting. In future research endeavors, we plan to explore these issues in conjunction with specific chemotherapy regimens. 5. Conclusion Patients with gastrointestinal lymphoma often experience GIB, GIO or GIP. Gastrointestinal complications can significantly reduce quality of life, prolong hospital stays, and decrease long-term survival rates. This study attempts to identify risk factors for GIB, GIO, and GIP in patients with primary gastrointestinal lymphoma through PSM analysis. Abbreviations gastrointestinal bleeding, GIB gastrointestinal obstruction, GIO gastrointestinal perforation, GIP propensity score matching, PSM gastrointestinal complications, GICs mucosa-associated lymphoid tissue, MALT follicular lymphoma, FL human immunodeficiency virus, HIV lactate dehydrogenase, LDH standard deviation, SD interquartile range, IQR Declarations Ethics approval and consent to participate This retrospective research was approved by The Medical Research Ethics Committee of The First Affiliated Hospital of Xi’an Jiaotong University and conducted in accordance with the declaration of Helsinki. All participants in this study have signed the informed consent form and agreed to participate in this study. Consent for publication All authors have read and approved the final manuscript for submission and agree with its publication in the journal. Availability of data and materials The datasets used in this study can be obtained from the corresponding author upon reasonable request. Competing Interests Authors state no conflict of interest. Funding There was no funding. Authors' contributions S. H. conceived and designed the study. Y.Z. and X.Z. performed the data collection, and analysis. Y.Z., Y.Z., D.N. and Y.L. wrote the initial manuscript draft. S.H. and Y.Z. contributed to manuscript revision. All authors have read and approved the final submitted version. Acknowledgements None. References aresh KN, Medeiros LJ, WHO Fifth Edition Classification Project. Introduction to the Fifth Edition of the World Health Organization Classification of Tumors of Hematopoietic and Lymphoid Tissues. Mod Pathol. 2023;36(12):100330. 10.1016/j.modpat.2023.100330 . Epub 2023 Sep 15. PMID: 37716508. Alvarez-Lesmes J, Chapman JR, Cassidy D, Zhou Y, Garcia-Buitrago M, Montgomery EA, Lossos IS, Sussman D, Poveda J. Gastrointestinal Tract Lymphomas. Arch Pathol Lab Med. 2021;145:1585–96. 10.5858/arpa.2020-0661-RA . Hanafy AK, Morani AC, Menias CO, Pickhardt PJ, Shaaban AM, Mujtaba B, Mellnick VM, Elsayes KM. Hematologic malignancies of the gastrointestinal luminal tract. Abdom Radiol (NY). 2020;45:3007–27. 10.1007/s00261-019-02278-8 . Nishimura MF, Nishimura Y, Nishikori A, Yoshino T, Sato Y. Primary Gastrointestinal T-Cell Lymphoma and Indolent Lymphoproliferative Disorders: Practical Diagnostic and Treatment Approaches. Cancers (Basel). 2021;13. 10.3390/cancers13225774 . Shen Y, Ou J, Wang B, Wang L, Xu J, Cen X. Influence of Severe Gastrointestinal Complications in Primary Gastrointestinal Diffuse Large B-Cell Lymphoma. Cancer Manag Res. 2021;13:1041–52. PMID: 33568947; PMCID: PMC7869708. Lai Q, Zhao Y, Yan H, Peng H. Advances in diagnosis, treatment and prognostic factors of gastrointestinal DLBCL. Leuk Res. 2023;135:107406. 10.1016/j.leukres.2023.107406 . Epub 2023 Oct 18. PMID: 37944240. Chen XY, Yang JY, Chen YH, Liu AN, Wu SS, Ji Zhi SN, Zheng SM. Primary duodenal T/histiocyte-rich large B-cell lymphoma complicated with obstructive jaundice: A case report and review of literature. World J Gastrointest Surg. 2025;17(1):99758. 10.4240/wjgs.v17.i1.99758 . PMID: 39872781; PMCID: PMC11757195. Filip PV, Vladareanu AM, Diaconu LS, Cuciureanu D, Tomescu A, Pop CS. Primary Gastrointestinal Lymphoma: A Prospective Unicentric Study on a Romanian Cohort. J Gastrointestin Liver Dis. 2025;34(1):23–29. 10.15403/jgld-6005 . PMID: 40117560. Kim DH, Lee D, Kim JW, Huh J, Park SH, Ha HK, Suh C, Yoon SM, Kim KJ, Choi KD, Ye BD, Byeon JS, Song HJ, Jung HY, Yang SK, Kim JH, Myung SJ. Endoscopic and clinical analysis of primary T-cell lymphoma of the gastrointestinal tract according to pathological subtype. J Gastroenterol Hepatol. 2014;29(5):934 – 43. 10.1111/jgh.12471 . PMID: 24325295. Catena F, De Simone B, Coccolini F, Di Saverio S, Sartelli M, Ansaloni L. Bowel obstruction: a narrative review for all physicians. World J Emerg Surg. 2019;14:20. 10.1186/s13017-019-0240-7 . Vaidya R, Habermann TM, Donohue JH, Ristow KM, Maurer MJ, Macon WR, Colgan JP, Inwards DJ, Ansell SM, Porrata LF, Micallef IN, Johnston PB, Markovic SN, Thompson CA, Nowakowski GS, Witzig TE. Bowel perforation in intestinal lymphoma: incidence and clinical features. Ann Oncol. 2013;24(9):2439–43. 10.1093/annonc/mdt188 . Epub 2013 May 22. PMID: 23704194; PMCID: PMC3755328. Moayyedi P, Eikelboom JW, Bosch J, Connolly SJ, Dyal L, Shestakovska O, Leong D, Anand SS, Störk S, Branch KRH, Bhatt DL, Verhamme PB, O'Donnell M, Maggioni AP, Lonn EM, Piegas LS, Ertl G, Keltai M, Cook Bruns N, Muehlhofer E, Dagenais GR, Kim JH, Hori M, Steg PG, Hart RG, Diaz R, Alings M, Widimsky P, Avezum A, Probstfield J, Zhu J, Liang Y, Lopez-Jaramillo P, Kakkar A, Parkhomenko AN, Ryden L, Pogosova N, Dans A, Lanas F, Commerford PJ, Torp-Pedersen C, Guzik T, Vinereanu D, Tonkin AM, Lewis BS, Felix C, Yusoff K, Metsarinne K, Fox KAA. Yusuf S COMPASS Investigators. Pantoprazole to Prevent Gastroduodenal Events in Patients Receiving Rivaroxaban and/or Aspirin in a Randomized, Double-Blind, Placebo-Controlled Trial. Gastroenterology. 2019;157:403–e4125. 10.1053/j.gastro.2019.04.041 . Barbaryan A, Ali AM, Kwatra SG, Saba R, Prueksaritanond S, Hussain N, Mirrakhimov AE, Vladimirskiy N, Zdunek T, Gilman AD. Primary diffuse large B-cell lymphoma of the ascending colon. Rare Tumors. 2013;5(2):85–8. PMID: 23888223; PMCID: PMC3719118. Modemann F, Ahmadi P, von Kroge PH, Weidemann S, Bokemeyer C, Dierlamm J, Fiedler W, Ghandili S. The prognostic impact of lymphoma perforation in patients with primary gastrointestinal lymphoma - a single-center analysis. Leuk Lymphoma. 2023 Nov-Dec;64(11):1801–10. Epub 2023 Aug 8. PMID: 37552203. Li JZ, Tao J, Ruan DY, Yang YD, Zhan YS, Wang X, Chen Y, Kuang SC, Shao CK, Wu B. Primary duodenal NK/T-cell lymphoma with massive bleeding: A case report. World J Clin Oncol. 2012;3(6):92–7. 10.5306/wjco.v3.i6.92 . PMID: 22724088; PMCID: PMC3380103. Chiang SW, Chiang TW. Colo-enteric fistula associated with diffuse large B cell lymphoma that resulted in gastrointestinal bleeding: A case report and literature review. Int J Surg Case Rep. 2022;91:106798. 10.1016/j.ijscr.2022.106798 . Epub 2022 Jan 31. PMID: 35131626; PMCID: PMC8829056. Zishan MA, Raufian K. A Delayed Presentation of Perforated Diffuse Large B Cell Lymphoma of the Small Bowel Resulting in a Large Interloop Faecaloma. Case Rep Surg. 2022;2022:3881598. 10.1155/2022/3881598 . PMID: 35572481; PMCID: PMC9098343. Hong YW, Kuo IM, Liu YY, Yeh TS. The role of surgical management in primary small bowel lymphoma: A single-center experience. Eur J Surg Oncol. 2017;43(10):1886–93. 10.1016/j.ejso.2017.06.016 . Epub 2017 Jul 18. PMID: 28751057. Zhuang N, Zhu Q, Li W, Wang M, Yang Q, Liu W, Li J, Yang H, Zhou W. Rare intestinal fistula caused by primary lymphoma of the gastrointestinal tract: Two case reports and literature review. Med (Baltim). 2018;97(27):e11407. 10.1097/MD.0000000000011407 . PMID: 29979438; PMCID: PMC6076109. hun HB, Baek IH, Lee MS, Kim JB, Shin SR, Kim BC, et al. Jejunocolic fistula associated with an intestinal T cell lymphoma. Gut Liver. 2011;5:387–90. 10.5009/gnl.2011.5.3.387 . Nijeboer P, de Baaij LR, Visser O, Witte BI, Cillessen SA, Mulder CJ, Bouma G. Treatment response in enteropathy associated T-cell lymphoma; survival in a large multicenter cohort. Am J Hematol. 2015;90(6):493–8. 10.1002/ajh.23992 . Epub 2015 May 10. PMID: 25716069. Plummer RM, Linden MA, Beckman AK. Update on B-cell lymphoproliferative disorders of the gastrointestinal tract. Semin Diagn Pathol. 2021;38(4):14–20. 10.1053/j.semdp.2021.03.006 . Epub 2021 Mar 26. PMID: 33863577. Nanthakwang N, Rattarittamrong E, Rattanathammethee T, Chai-Adisaksopha C, Tantiworawit A, Norrasethada L, Ya-In C. Clinicopathological study and outcomes of primary extranodal lymphoma. Hematol Rep. 2019;11(4):8227. PMID: 31871611; PMCID: PMC6902274. Tran QT, Nguyen Duy T, Nguyen-Tran BS, Nguyen-Thanh T, Ngo QT, Tran Thi NP, Le V, Dang-Cong T. Endoscopic and Histopathological Characteristics of Gastrointestinal Lymphoma: A Multicentric Study. Diagnostics (Basel). 2023;13(17):2767. 10.3390/diagnostics13172767 . PMID: 37685305; PMCID: PMC10486743. Tian FY, Wang JX, Huang G, An W, Ai LS, Wang S, Wang PZ, Yu YB, Zuo XL, Li YQ. Clinical and endoscopic features of primary small bowel lymphoma: a single-center experience from mainland China. Front Oncol. 2023;13:1142133. 10.3389/fonc.2023.1142133 . PMID: 37397371; PMCID: PMC10313208. Kim JH, Lee JH, Lee J, Oh SO, Chang DK, Rhee PL, Kim JJ, Rhee JC, Lee J, Kim WS, Ko YH. Primary NK-/T-cell lymphoma of the gastrointestinal tract: clinical characteristics and endoscopic findings. Endoscopy. 2007;39(2):156 – 60. 10.1055/s-2006-945114 . PMID: 17657701. Kanno T, Katano T, Shimura T, Nishigaki R, Kojima Y, Sasaki M, Okuda Y, Sugimura N, Fukusada S, Mizuno Y, Iwasaki H, Nishie H, Tanaka M, Ozeki K, Kubota E, Tanida S, Kataoka H. Characteristic endoscopic findings of gastrointestinal malignant lymphomas other than mucosa-associated lymphoid tissue lymphoma. Acta Gastroenterol Belg 2022 Jul-Sep;85(3):477–83. doi: 10.51821/85.3.9712. Epub 2022 Jun 21. PMID: 35770281. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Published Journal Publication published 03 Mar, 2026 Read the published version in BMC Gastroenterology → Version 1 posted Editorial decision: Revision requested 13 Jan, 2026 Reviews received at journal 12 Jan, 2026 Reviewers agreed at journal 04 Jan, 2026 Reviewers agreed at journal 24 Dec, 2025 Reviews received at journal 08 Dec, 2025 Reviewers agreed at journal 08 Dec, 2025 Reviewers invited by journal 26 Nov, 2025 Editor invited by journal 25 Nov, 2025 Editor assigned by journal 25 Sep, 2025 Submission checks completed at journal 24 Sep, 2025 First submitted to journal 24 Sep, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7621218","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":552170588,"identity":"e78de354-5279-466f-9e0e-f0554f703acb","order_by":0,"name":"Yahan Zhao","email":"","orcid":"","institution":"the First Affiliated Hospital of Xi'an Jiaotong University","correspondingAuthor":false,"prefix":"","firstName":"Yahan","middleName":"","lastName":"Zhao","suffix":""},{"id":552170589,"identity":"881cb180-f04f-4ac5-84ec-150a7ce150d6","order_by":1,"name":"Xuchen Zhang","email":"","orcid":"","institution":"the First Affiliated Hospital of Xi'an Jiaotong University","correspondingAuthor":false,"prefix":"","firstName":"Xuchen","middleName":"","lastName":"Zhang","suffix":""},{"id":552170590,"identity":"483e91fa-01f5-4b0f-af54-a362550b562c","order_by":2,"name":"Yuanzhi Zhou","email":"","orcid":"","institution":"the First Affiliated Hospital of Xi'an Jiaotong University","correspondingAuthor":false,"prefix":"","firstName":"Yuanzhi","middleName":"","lastName":"Zhou","suffix":""},{"id":552170591,"identity":"acc30ba1-af62-4bf6-b140-7c8175fe4cfa","order_by":3,"name":"Dai Nan","email":"","orcid":"","institution":"the First Affiliated Hospital of Xi'an Jiaotong University","correspondingAuthor":false,"prefix":"","firstName":"Dai","middleName":"","lastName":"Nan","suffix":""},{"id":552170592,"identity":"ab1fc3df-2532-4690-8dde-8ff9ea811471","order_by":4,"name":"Yarui Li","email":"","orcid":"","institution":"the First Affiliated Hospital of Xi'an Jiaotong University","correspondingAuthor":false,"prefix":"","firstName":"Yarui","middleName":"","lastName":"Li","suffix":""},{"id":552170593,"identity":"7872cfbb-a4f1-4469-a2b3-2992cba2f053","order_by":5,"name":"Shuixiang He","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABE0lEQVRIiWNgGAWjYDCCA2CSjUGCvYGBIaGAgYGxASJAhBYeICvBAKiljTgtDAwSEglA0gCmGo8WvhsJbBKMbXyJM2e+TvzwwIAhsXl+jwHDh7LDDPyzG7BqkYRoYTOWls7dLAF0mDFjG48B44xzhxkk7hzAqsUAqkVOTjp3A0iLHEgLM2/bYQYDsFNxa+GRkzy7+QdQCw9Yy18itMhJS/BuQ9jCiEeL5JmHzRYJ59iMJXtyt1kkGEgA/ZJWcLDnXDqPxA3sWviOJx+88aHsWOKM42c33/xRYZO4sfnwxgc/yqzl+Gdg18IgkNgikch2DMaVYDBsgEQWD3b1QMB/gPkDw58ahIA8TqWjYBSMglEwUgEAi6ZX7osSfz0AAAAASUVORK5CYII=","orcid":"","institution":"the First Affiliated Hospital of Xi'an Jiaotong University","correspondingAuthor":true,"prefix":"","firstName":"Shuixiang","middleName":"","lastName":"He","suffix":""}],"badges":[],"createdAt":"2025-09-15 13:38:35","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7621218/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7621218/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12876-026-04666-z","type":"published","date":"2026-03-03T15:59:38+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":97115315,"identity":"61809c2f-57c9-4474-9c99-54f10f850d2c","added_by":"auto","created_at":"2025-12-01 07:03:46","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":54575,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript0912.docx","url":"https://assets-eu.researchsquare.com/files/rs-7621218/v1/cf74b7a9df40618233d33984.docx"},{"id":97115323,"identity":"853ed0e8-a8c5-49cf-869c-a14d6dfc81bc","added_by":"auto","created_at":"2025-12-01 07:03:47","extension":"json","order_by":1,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":7502,"visible":true,"origin":"","legend":"","description":"","filename":"1b9ad0291bc4479cbf634b3243bbbf56.json","url":"https://assets-eu.researchsquare.com/files/rs-7621218/v1/6fb219438d2e393d7846c158.json"},{"id":97115327,"identity":"3ac8de7d-541b-40fd-a579-339e37ce13d4","added_by":"auto","created_at":"2025-12-01 07:03:47","extension":"xml","order_by":2,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":141025,"visible":true,"origin":"","legend":"","description":"","filename":"1b9ad0291bc4479cbf634b3243bbbf561enriched.xml","url":"https://assets-eu.researchsquare.com/files/rs-7621218/v1/50fe8782f52c8819c6132b98.xml"},{"id":97141882,"identity":"9581d500-2abe-4e42-b1eb-5d9bf8784283","added_by":"auto","created_at":"2025-12-01 10:07:08","extension":"xml","order_by":3,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":139397,"visible":true,"origin":"","legend":"","description":"","filename":"1b9ad0291bc4479cbf634b3243bbbf561structuring.xml","url":"https://assets-eu.researchsquare.com/files/rs-7621218/v1/726ab2df78b5216277994878.xml"},{"id":97142213,"identity":"d4dd3cd5-a0c4-4883-97c4-707c59e266d8","added_by":"auto","created_at":"2025-12-01 10:07:25","extension":"html","order_by":4,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":145263,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-7621218/v1/124b9d5e903d6807ea2eb247.html"},{"id":104250794,"identity":"b9ee0182-5f8c-4d3d-9c56-72fab7b023c0","added_by":"auto","created_at":"2026-03-09 16:08:43","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":860854,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7621218/v1/6e1708db-d410-4f76-b44d-82b9a8dac8b7.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"The risk of digestive tract complications in patients with gastrointestinal lymphoma: A propensity score study","fulltext":[{"header":"1. Introduction","content":"\u003cp\u003ePrimary extranodal lymphoma is defined as a type of lymphoma that originates in tissues and organs other than the lymph nodes, rather than primarily involving the lymph nodes.[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e] The digestive system, particularly the gastrointestinal tract, is rich in lymphatic tissue, making it a common site for lymphoma invasion. Primary gastrointestinal lymphomas, although less frequent than epithelial cancers, still account for approximately 1% of all gastrointestinal tumors. Among these, the stomach is the most frequently affected organ, followed by the small and large intestines. In contrast, involvement of the esophagus, appendix, and rectum is relatively rare.[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e] Primary gastrointestinal lymphoma can be categorized into B-cell lymphoma and natural killer (NK)/T-cell lymphoma. Additionally, based on the disease course, it is divided into aggressive and indolent types. Indolent B-cell lymphomas, such as mucosa-associated lymphoid tissue (MALT) lymphoma and follicular lymphoma (FL), typically cause minimal invasive damage to the gastrointestinal tract.[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e] Primary gastrointestinal T/NK cell lymphomas (PGI-TNKL) are aggressive malignancies that encompass a variety of subtypes, each characterized by distinct clinicopathological features and prognoses.[\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e] Aggressive gastrointestinal lymphomas exhibit more invasive growth patterns and carry a worse prognosis compared to their indolent counterparts. When aggressive lymphomas occur in the gastrointestinal tract, severe gastrointestinal complications (GICs) such as gastrointestinal bleeding (GIB), gastrointestinal obstruction (GIO), and gastrointestinal perforation (GIP) are also common at the time of initial presentation. These complications are particularly prevalent after chemotherapy. Notably, GIP can lead to a very high mortality rate.[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]\u003c/p\u003e\u003cp\u003eTimely identification of risk factors for GICs may facilitate early intervention and improve the prognosis for patients with aggressive gastrointestinal lymphoma. In a retrospective analysis of 148 patients, 56.8% experienced GICs, encompassing GIB, GIO, GIP, and multiple complications.[\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e] Patients with gastrointestinal lymphoma who develop GICs, such as GIB, GIO and GIP, and others, experience a significant decline in quality of life and may face severe clinical consequences, including life-threatening situations.[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e] The occurrence of these complications was related to the aggressiveness of the tumor and the complexity of the treatment, and may indicated disease progression.[\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e] Therefore, early identification and active treatment of these complications are crucial for improving patients\u0026rsquo; prognosis. However, there was no systematic summary of the risks of GICs in primary gastrointestinal lymphoma in current studies.\u003c/p\u003e\u003cp\u003eAccurately identifying high-risk patients for GICs among primary gastrointestinal lymphoma patients was crucial for improving treatment outcomes and overall survival. In this study, we attempted to systematically analyze diagnosed with primary gastrointestinal lymphoma at our medical center in the past. We compared various indicators between the GICs group and the No-GICs group, identified risk factors for predicting GICs, which is conducive to the early identification of GICs by clinicians and attempts to provide evidence-based support for treatment.\u003c/p\u003e"},{"header":"2. Materials and Methods","content":"\u003cp\u003e\u003cb\u003ePatient Selection and evaluation criterion\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThe patients included inpatient and outpatient lymphoma patients at our hospital from January 2014 and January 2024, and followed up until January 2025. Follow-up methods included in-patient review, outpatient review, and telephone follow-up. Primary gastrointestinal lymphoma was defined as predominant lesions in the alimentary tract with or without regional lymph node involvement.[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e] All cases were diagnosed according to the World Health Organization diagnostic criteria.[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e] All patients underwent gastroscopy and colonoscopy. The exclusion criteria were as follows: age under 18 years, infection with human immunodeficiency virus (HIV), lack of informed consent, inconsistent pathological diagnosis, or inability to undergo gastroscopy and colonoscopy.\u003c/p\u003e\u003cp\u003eThe clinical data of all patients at the time of initial diagnosis were collected in our cancer center, including age, gender, BMI, disease stage, blood lactate dehydrogenase (LDH), albumin, hemoglobin, symptoms, treatment methods and endoscopy or endoscopic ultrasonography. This retrospective research was approved by The Medical Research Ethics Committee of The First Affiliated Hospital of Xi\u0026rsquo;an Jiaotong University and conducted in accordance with the declaration of Helsinki.\u003c/p\u003e\u003cp\u003e\u003cb\u003eMacroscopy/endoscopy\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThe macroscopic characteristics of lesions, including their morphology and size, were meticulously reviewed by a panel of expert endoscopists and pathologists. These assessments were based on detailed endoscopic observations and/or histopathological examination of specimens obtained from surgical resection. The lesion morphology was classified into four distinct categories: ulcerative, exophytic, hyperplastic, and punctate hemorrhage.\u003c/p\u003e\u003cp\u003e\u003cb\u003eEvaluation outcome criteria\u003c/b\u003e\u003c/p\u003e\u003cp\u003eGICs were confirmed by clinical symptoms, laboratory tests, imaging, and/or surgery. GIO, including partial and complete obstruction, was considered to be the absence of passage of flatus or feces.[\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e] GIP was defined as the presence of free air under the diaphragm on abdominal imaging, or intestinal perforation during laparotomy.[\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e] GIB was defined as overt bleeding (hematemesis, bloody stools) and drop in hemoglobin of \u0026ge;\u0026thinsp;2 g/dL.[\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e] All the above GICs were confirmed using imaging or surgery. During the course of the disease, it was possible to develop two or more complications.\u003c/p\u003e\u003cp\u003e\u003cb\u003eStatistical analysis\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThe statistical analysis of the data was conducted using SPSS 26.0 (IBM Corp, Armonk, NY, USA). To ensure comparability between groups, propensity score matching (PSM) was utilized to perform 1:1 matching with a tolerance level of 0.02. The variables incorporated into the matching process included age, body mass index (BMI), sex, type of operative treatment, and disease stage.\u003c/p\u003e\u003cp\u003eTo evaluate the distribution of continuous variables within the sample, the Kolmogorov-Smirnov test was employed. Quantitative data that adhered to a normal distribution were reported as mean\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation (SD), while those exhibiting a non-normal distribution were described using the interquartile range (IQR). Categorical data were presented as frequency and proportion.\u003c/p\u003e\u003cp\u003eFor statistical comparisons, normally distributed quantitative data were analyzed using the independent samples t-test. In contrast, non-normally distributed data were assessed using the nonparametric Wilcoxon rank-sum test. Categorical data were examined using the chi-square test, Fisher\u0026rsquo;s exact test, or rank-sum test, as appropriate for the specific analysis.\u003c/p\u003e"},{"header":"3. Results","content":"\u003cp\u003e\u003cstrong\u003eGIB\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study included a total of 347 patients. Before (PSM), there were 272 patients in the non-GIB group and 75 patients in the GIB group. After PSM, both the non-GIB and GIB groups had 75 patients each. Before PSM, the mean age of patients in the non-GIB group was 57.03\u0026plusmn;14.33 years, and in the GIB group, it was 57.45\u0026plusmn;16.02 years. After PSM, the mean age of patients in the non-GIB group was 58.08\u0026plusmn;15.55 years, and in the GIB group, it remained 57.45\u0026plusmn;16.02 years. The P-values for age differences between the two groups were not statistically significant both before and after PSM. Before PSM, the non-GIB group had 143 males (52.6%), and the GIB group had 42 males (56.0%). After PSM, the non-GIB group had 41 males (54.7%), and the GIB group had 42 males (56.0%). Before PSM, there was a significant statistical difference in the number of patients who underwent surgical treatment between the two groups (P=0.004). After PSM, all baseline indicators between the two groups were not statistically significant (P\u0026gt;0.05).(shown in Table 1.)\u003c/p\u003e\n\u003cp\u003eTable 1. Comparison of the clinical baseline data between the two groups for GIB\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"680\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003eBefore PSM\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003et/x\u003csup\u003e2\u003c/sup\u003e/z\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 161px;\"\u003e\n \u003cp\u003eAfter PSM\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003et/x\u003csup\u003e2\u003c/sup\u003e/z\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003eNon-GIB group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003eGIB group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003eNon-GIB group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003eGIB group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003en\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e272\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003en\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eAge(years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e57.03\u0026plusmn;14.33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e57.45\u0026plusmn;16.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e-0.223\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e0.824\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eAge(years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e58.08\u0026plusmn;15.55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e57.45\u0026plusmn;16.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e0.243\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e0.808\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eBMI(kg/m\u003csup\u003e2\u003c/sup\u003e)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e24.71\u0026plusmn;3.33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e23.84\u0026plusmn;4.41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e0.661\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e0.511\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eBMI(kg/m2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e24.42\u0026plusmn;3.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e23.81\u0026plusmn;4.51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e0.651\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e0.515\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eMale(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e143(52.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e42(56.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e0.277\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e0.598\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eMale(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e41(54.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e42(56.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e0.027\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e0.870\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eOperative treatment(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e229(84.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e52(69.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e8.426\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e0.004\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eOperative treatment(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e63(84.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e52(69.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e4.509\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e0.034\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eStage(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e1.135\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e0.769\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eStage(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e1.924\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e0.588\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e53(19.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e17(22.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e11(14.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e17(22.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eII\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e52(19.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e17(22.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eII\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e17(22.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e17(22.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eIII\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e51(18.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e12(16.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eIII\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e16(21.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e12(16.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eIV\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e116(42.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e29(38.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eIV\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e31(41.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e29(38.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eAfter propensity score matching (PSM), there were 75 patients in both the non-GIB and GIB groups (matched at a 1:1 ratio). Among all the indicators included in this study, hemoglobin levels showed a significant difference between the two groups (112.57\u0026plusmn;19.95 vs. 100.24\u0026plusmn;23.20, P=0.041); LDH levels also showed a significant difference (272.00, 189.00-399.00 vs. 188.00, 166.00-230.90, P=0.011). Regarding abdominal symptoms, abdominal pain was significantly different between the two groups (P=0.027).(shown in Table 2.)\u003c/p\u003e\n\u003cp\u003eTable 2. Comparison of the clinical variables for between the two groups of patients after propensity score matching\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eEvaluation indicators\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eNon-GIB group(n=75)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eGIB group(n=75)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003et/x\u003csup\u003e2\u003c/sup\u003e/z\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eALB(g/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e34.60\u0026plusmn;6.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e36.32\u0026plusmn;6.14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e-1.692\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e0.093\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eHGB(g/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e112.57\u0026plusmn;19.95\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e100.24\u0026plusmn;23.20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e-3.189\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e0.041\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eLDH(U/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e272.00(189.00, 399.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e188.00(166.00, 230.90)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e-4.150\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e0.011\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003ePA(mg/dl)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e175.40(116.50, 221.10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e177.00(115.30, 206.20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e-0.566\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e0.572\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eIPI class(%) \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e5.679\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e0.339\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e9(12.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e8(10.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e10(13.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e18(24.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e23(30.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e28(37.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e17(22.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e12(16.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e12(16.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e7(9.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e4(5.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e2(2.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eSymptoms(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e36(48)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e40(53.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e0.427\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e0.514\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eStomachache(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e14(18.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e26(34.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e4.909\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e0.027\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eVomiting(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e22(29.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e19(25.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e0.302\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e0.583\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eConstipation(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e25(33.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e30(40)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e2.117\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e0.311\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eEndoscope types(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e1.847\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e0.605\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eUlcerative type\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e25(33.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e32(42.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eExogenous type\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e25(33.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e20(26.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eHyperplastic type\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e13(17.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e10(13.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003ePunctate hemorrhage\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e12(16)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e13(17.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eNote: ALB, Albumin; HGB, hemoglobin; LDH, blood lactate dehydrogenase; PA, Prealbumin; IPI, International Prognostic Index\u003cbr\u003e\u003cstrong\u003eGIO\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eBefore PSM, there were 302 patients in the non-GIO group and 45 patients in the GIO group. After PSM, both the non-GIO and GIO groups had 45 patients each. Before PSM, the mean age of patients in the non-GIO group was 57.12\u0026plusmn;14.43 years, and in the GIO group, it was 56.40\u0026plusmn;17.13 years. After PSM, the mean age of patients in the non-GIO group was 55.00\u0026plusmn;16.74 years, and in the GIO group, it remained 56.40\u0026plusmn;17.13 years. The P-values for age differences between the two groups were not statistically significant both before and after PSM. Before PSM, there was a significant statistical difference in the number of patients who underwent surgical treatment between the two groups (P=0.001). After PSM, all baseline indicators between the two groups were not statistically significant (P\u0026gt;0.05).(shown in Table 3.)\u003c/p\u003e\n\u003cp\u003eTable 3. Comparison of the clinical baseline data between the two groups for GIB\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"680\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003eBefore PSM\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003et/x\u003csup\u003e2\u003c/sup\u003e/z\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 161px;\"\u003e\n \u003cp\u003eAfter PSM\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003et/x\u003csup\u003e2\u003c/sup\u003e/z\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003eNon-GIO group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003eGIO group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003eNon-GIO group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003eGIO group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003en\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e302\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003en\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eAge(years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e57.12\u0026plusmn;14.43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e56.40\u0026plusmn;17.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e0.305\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e0.760\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eAge(years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e55.00\u0026plusmn;16.74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e56.40\u0026plusmn;17.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e-0.392\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e0.696\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eBMI(kg/m\u003csup\u003e2\u003c/sup\u003e)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e24.52\u0026plusmn;3.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e23.62\u0026plusmn;4.22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e0.787\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e0.497\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eBMI(kg/m2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e24.25\u0026plusmn;3.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e23.62\u0026plusmn;4.22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e0.688\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e0.534\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eMale(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e158(52.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e26(57.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e0.469\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e0.494\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eMale(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e25(55.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e26(57.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e0.045\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e0.832\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eOperative treatment(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e75(24.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e25(55.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e18.019\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eOperative treatment(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e15(33.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e25(55.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e4.500\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e0.064\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eStage(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e5.386\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e0.146\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eStage(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e2.203\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e0.532\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e61(20.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e10(22.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e8(17.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e10(22.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eII\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e50(16.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e13(28.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eII\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e9(20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e13(28.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eIII\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e62(20.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e5(11.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eIII\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e9(20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e5(11.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eIV\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e129(42.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e17(37.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eIV\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e19(42.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e17(37.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eAfter PSM, both the GIO and non-GIO groups had 45 patients each. Among all the indicators included, there were significant differences between the two groups in stomachache (28 [62.2%] vs. 37 [82.2%], P=0.034) and vomiting (12 [26.7%] vs. 21 [46.6%], P=0.031). There was also a significant difference in the type of endoscopy between the two groups (P=0.022). Notably, hyperplastic lesions were significantly more common in the GIO group than in the non-GIO group.(shown in Table 4.)\u003c/p\u003e\n\u003cp\u003eTable 4. Comparison of the clinical variables for between the two groups of patients after propensity score matching\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eEvaluation indicators\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eNon-GIO group(n=45)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eGIO group(n=45)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003et/x\u003csup\u003e2\u003c/sup\u003e/z\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eALB(g/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e35.12\u0026plusmn;6.27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e32.83\u0026plusmn;6.41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e1.712\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e0.090\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eHGB(g/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e108.49\u0026plusmn;25.37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e108.29\u0026plusmn;23.37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e0.039\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e0.969\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eLDH(U/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e210.00(169.50, 339.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e208.00(167.00, 316.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e-0.529\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e0.597\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003ePA(mg/dl)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e193.30(122.10, 217.30)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e140.80(91.45, 208.35)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e-1.537\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e0.124\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eIPI class(%) \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e3.923\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e0.561\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e6(13.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e5(11.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e13(28.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e15(33.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e10(22.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e7(15.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e14(31.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e11(24.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e1(2.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e3(6.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e1(2.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e4(8.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eSymptoms(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e21(46.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e26(57.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e1.113\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e0.291\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eStomachache(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e28(62.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e37(82.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e4.486\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e0.034\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eVomiting(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e12(26.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e21(46.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e4.216\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e0.031\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eConstipation(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e16(35.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e14(31.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e0.200\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e0.655\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eEndoscope types(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e5.343\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e0.022\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eUlcerative type\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e16(35.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e10(22.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eExogenous type\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e15(33.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e10(22.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eHyperplastic type\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e7(15.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e21(46.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003ePunctate hemorrhage\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e7(15.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e4(8.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eNote: ALB, Albumin; HGB, hemoglobin; LDH, blood lactate dehydrogenase; PA, Prealbumin; IPI, International Prognostic Index\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eGIP\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFor the complication of GIP, before PSM, there were 319 patients in the non-GIP group and 28 patients in the GIP group. After PSM, both groups had 28 patients each. After PSM, there were no significant differences in all baseline indicators between the two groups (P \u0026gt; 0.05). The age of patients in the non-GIP group was 55.14\u0026plusmn;18.45, and in the GIP group, it was 55.07\u0026plusmn;18.61. The proportion of males was 16 (57.1%) in the non-GIP group and also 16 (57.1%) in the GIP group. Among the non-GIP group, 11 (39.3%) patients underwent surgical treatment, while in the GIP group, 7 (25.0%) patients underwent surgical treatment.(shown in Table 5.)\u003c/p\u003e\n\u003cp\u003eTable 5. Comparison of the clinical baseline data between the two groups for GIP\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"680\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003eBefore PSM\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003et/x\u003csup\u003e2\u003c/sup\u003e/z\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 161px;\"\u003e\n \u003cp\u003eAfter PSM\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003et/x\u003csup\u003e2\u003c/sup\u003e/z\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003eNon-GIP group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003eGIP group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003eNon-GIP group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003eGIP group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003en\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e319\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003en\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eAge(years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e57.10\u0026plusmn;14.43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e55.07\u0026plusmn;18.61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e0.695\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e0.487\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eAge(years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e55.14\u0026plusmn;18.45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e55.07\u0026plusmn;18.61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e0.014\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e0.989\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eBMI(kg/m\u003csup\u003e2\u003c/sup\u003e)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e24.96\u0026plusmn;3.32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e24.22\u0026plusmn;4.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e0.811\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e0.507\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eBMI(kg/m2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e24.22\u0026plusmn;3.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e24.22\u0026plusmn;4.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e0.667\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e0.431\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eMale(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e168(52.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e16(57.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e0.207\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e0.649\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eMale(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e16(57.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e16(57.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eOperative treatment(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e93(29.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e7(25.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e0.216\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e0.642\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eOperative treatment(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e11(39.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e7(25.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e1.310\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e0.252\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eStage(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e8.966\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e0.030\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eStage(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e5.493\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e0.139\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e67(21.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e3(10.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e3(10.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e3(10.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eII\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e55(17.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e8(28.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eII\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e7(25.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e8(28.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eIII\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e68(21.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e1(3.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eIII\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e7(25.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e1(3.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eIV\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e129(40.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e16(57.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eIV\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e11(39.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e16(57.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eFor GIP, after propensity score matching (PSM), there was a significant difference in hemoglobin levels between the two groups (119.5\u0026plusmn;22.32 vs. 102.79\u0026plusmn;25.50, P=0.012). Similarly, there were significant differences between the groups in terms of stomachache (16 [57.1%] vs. 23 [82.1%], P=0.048) and constipation (8 [28.6%] vs. 3 [10.7%], P=0.043). Regarding endoscope types, there was a significant difference in the prevalence of ulcerative lesions between the groups (4 [14.2%] vs. 12 [42.9%]). (shown in Table 6.)\u003c/p\u003e\n\u003cp\u003eTable 6. Comparison of the clinical variables for between the two groups of patients after propensity score matching\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eEvaluation indicators\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eNon-GIB group(n=75)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eGIB group(n=75)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003et/x\u003csup\u003e2\u003c/sup\u003e/z\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eALB(g/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e34.60\u0026plusmn;6.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e36.32\u0026plusmn;6.14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e-1.692\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e0.093\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eHGB(g/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e112.57\u0026plusmn;19.95\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e100.24\u0026plusmn;23.20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e-3.189\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e0.041\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eLDH(U/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e272.00(189.00, 399.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e188.00(166.00, 230.90)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e-4.150\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e0.011\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003ePA(mg/dl)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e175.40(116.50, 221.10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e177.00(115.30, 206.20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e-0.566\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e0.572\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eIPI class(%) \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e5.679\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e0.339\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e9(12.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e8(10.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e10(13.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e18(24.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e23(30.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e28(37.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e17(22.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e12(16.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e12(16.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e7(9.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e4(5.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e2(2.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eSymptoms(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e36(48)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e40(53.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e0.427\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e0.514\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eStomachache(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e14(18.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e26(34.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e4.909\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e0.027\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eVomiting(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e22(29.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e19(25.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e0.302\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e0.583\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eConstipation(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e25(33.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e30(40)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e2.117\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e0.311\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eEndoscope types(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e1.847\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e0.605\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eUlcerative type\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e25(33.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e32(42.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eExogenous type\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e25(33.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e20(26.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eHyperplastic type\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e13(17.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e10(13.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003ePunctate hemorrhage\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e12(16)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e13(17.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eNote: ALB, Albumin; HGB, hemoglobin; LDH, blood lactate dehydrogenase; PA, Prealbumin; IPI, International Prognostic Index\u003c/p\u003e"},{"header":"4. Discussion","content":"\u003cp\u003ePrimary gastrointestinal lymphoma has the potential to arise in any segment of the digestive tract. It is most frequently encountered in the stomach, with the small intestine being the next common site, followed by the colon and rectum. In contrast, its occurrence in the esophagus is relatively rare.[\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e] Owning to the rapid progression of the primary gastrointestinal lymphoma, the enlargement and invasive characteristics of the mass were easy to cause GICs, the management of GICs remained a clinical challenge.[\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e] GICs were life-threatening acute abdomens such as GIO, GIP, and GIB. In particular, the perforation rate of small intestine was more than 50%, and the mortality rate was high.[\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e] In our study of primary gastrointestinal lymphoma cohort, GICs occurred in 34.0% of patients. In our study, GIB occurred in 75 cases (21.6%), GIO occurred in 45 cases (12.9%) and GIP occurred in 28 cases (8.0%). PSM analysis indicated that decreased hemoglobin and LDH levels, as well as the presence of stomachache, are high-risk factors for the development of GIB. Stomachache, vomiting, and endoscopic evidence of hyperplastic lesions are identified as high-risk factors for GIO. Moreover, patients with endoscopic findings of ulcerative lesions, decreased hemoglobin levels, stomachache, and constipation are more likely to experience GIP.\u003c/p\u003e\u003cp\u003eStomachache serves as a crucial warning sign in patients with primary gastrointestinal lymphoma, potentially signaling the emergence of severe complications such as bleeding, perforation, or obstruction. Timely identification and intervention are vital for enhancing patient outcomes.[\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e] This is mainly related to the growth pattern, location of the tumor and its impact on the surrounding tissues.[\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e] Tumor growth may induce the formation of mucosal ulcers, which can subsequently lead to bleeding or perforation. Concurrently, the mechanical compression exerted by the tumor can cause narrowing of the gastrointestinal lumen, resulting in obstruction.[\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e] The growth patterns of these tumors can lead to acute abdomen syndromes, which are primarily characterized by abdominal pain, such as obstruction, perforation, bleeding, and intussusception. Moreover, certain highly aggressive lymphoma types and the side effects of chemotherapy may further increase the risk of these complications.[\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e] Thus, in these patients, abdominal pain serves as a vital warning signal that may herald the onset of severe complications. Timely identification and treatment are of utmost importance for improving patient outcomes.\u003c/p\u003e\u003cp\u003ePrimary gastrointestinal lymphoma often manifests as submucosal tumors. As the tumor grows, it can lead to the formation of mucosal ulcers, which in turn can cause bleeding.[\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e] This bleeding may present as hematemesis, melena, or hematochezia, resulting in a decrease in hemoglobin levels.[\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e] Further development of the ulcers may perforate the gastrointestinal wall, leading to perforation. Perforation can cause peritonitis, characterized by severe abdominal pain, fever, and abdominal muscle rigidity, and in severe cases, may lead to sepsis and shock. Perforation can also cause internal bleeding, further reducing hemoglobin levels.[\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e] Chemotherapy or the natural progression of the tumor may lead to tumor necrosis.[\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e] Necrotic tissue releases LDH into the bloodstream, causing an increase in LDH levels.[\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e] Along with tumor progression and necrosis, the risk of gastrointestinal bleeding and perforation also increases. Therefore, changes in hemoglobin and LDH levels are important clinical indicators that can help doctors to identify severe complications such as bleeding and perforation at an early stage. Timely diagnosis and treatment are crucial for improving patients' prognosis.\u003c/p\u003e\u003cp\u003eUlcers have the potential to erode blood vessels within the gastrointestinal wall, thereby triggering acute bleeding. This form of bleeding may present as hematemesis, which is the vomiting of blood, melena characterized by black, tarry stools, or hematochezia indicated by bright red blood in the stool. In particularly severe instances, it can progress to hemorrhagic shock.[\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e] The risk of blood vessel erosion increases with the depth and extent of the ulcers. When ulcers are larger, they are more likely to penetrate multiple layers of the gastrointestinal wall, thereby heightening the probability of bleeding.[\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e] Primary gastrointestinal lymphoma exhibits a certain degree of invasiveness, with tumor cells potentially invading blood vessels directly, thereby causing bleeding. Petechial bleeding typically signifies that the gastrointestinal mucosa has already sustained damage and that the tissue has become fragile. This increased fragility elevates the risk of gastrointestinal wall perforation.[\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e] Petechial bleeding may be associated with local inflammation and tissue necrosis. Necrotic tissue is more prone to rupture, which can lead to perforation. Chemotherapy can induce tumor cell necrosis and shedding, causing further damage to the gastrointestinal mucosa and thereby increasing the risk of perforation. [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e] The detection of ulcers and petechial bleeding during endoscopy is an important warning sign, indicating that patients may be at risk of bleeding and perforation. Early identification of these risks and the implementation of appropriate interventions are crucial for improving patients' prognosis.\u003c/p\u003e\u003cp\u003eThis study is a limited-scale, single-center retrospective investigation with a relatively small sample size. Given these limitations, it is essential to conduct large-scale prospective trials to identify appropriate predictors for GIB, GIO and GIP. There is a wide array of chemotherapy regimens available for primary gastrointestinal lymphoma, and these treatments often induce a variety of gastrointestinal complications, including bleeding, obstruction, and vomiting. In future research endeavors, we plan to explore these issues in conjunction with specific chemotherapy regimens.\u003c/p\u003e"},{"header":"5. Conclusion","content":"\u003cp\u003ePatients with gastrointestinal lymphoma often experience GIB, GIO or GIP. Gastrointestinal complications can significantly reduce quality of life, prolong hospital stays, and decrease long-term survival rates. This study attempts to identify risk factors for GIB, GIO, and GIP in patients with primary gastrointestinal lymphoma through PSM analysis.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003egastrointestinal bleeding, GIB\u003c/p\u003e\n\u003cp\u003egastrointestinal obstruction, GIO\u003c/p\u003e\n\u003cp\u003egastrointestinal perforation, GIP\u003c/p\u003e\n\u003cp\u003epropensity score matching, PSM\u003c/p\u003e\n\u003cp\u003egastrointestinal complications, GICs\u003c/p\u003e\n\u003cp\u003emucosa-associated lymphoid tissue, MALT\u003c/p\u003e\n\u003cp\u003efollicular lymphoma, FL\u003c/p\u003e\n\u003cp\u003ehuman immunodeficiency virus, HIV\u003c/p\u003e\n\u003cp\u003elactate dehydrogenase, LDH\u003c/p\u003e\n\u003cp\u003estandard deviation, SD\u003c/p\u003e\n\u003cp\u003einterquartile range, IQR\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis retrospective research was approved by The Medical Research Ethics Committee of The First Affiliated Hospital of Xi\u0026rsquo;an Jiaotong University and conducted in accordance with the declaration of Helsinki. All participants in this study have signed the informed consent form and agreed to participate in this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll authors have read and approved the final manuscript for submission and agree with its publication in the journal.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used in this study can be obtained from the corresponding author upon reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting Interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAuthors state no conflict of interest.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThere was no funding.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eS. H. conceived and designed the study. Y.Z. and X.Z. performed the data collection, and analysis. Y.Z., Y.Z., D.N. and Y.L. wrote the initial manuscript draft. S.H. and Y.Z. contributed to manuscript revision. All authors have read and approved the final submitted version.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNone.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003earesh KN, Medeiros LJ, WHO Fifth Edition Classification Project. Introduction to the Fifth Edition of the World Health Organization Classification of Tumors of Hematopoietic and Lymphoid Tissues. Mod Pathol. 2023;36(12):100330. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.modpat.2023.100330\u003c/span\u003e\u003cspan address=\"10.1016/j.modpat.2023.100330\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Epub 2023 Sep 15. PMID: 37716508.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eAlvarez-Lesmes J, Chapman JR, Cassidy D, Zhou Y, Garcia-Buitrago M, Montgomery EA, Lossos IS, Sussman D, Poveda J. Gastrointestinal Tract Lymphomas. Arch Pathol Lab Med. 2021;145:1585\u0026ndash;96. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.5858/arpa.2020-0661-RA\u003c/span\u003e\u003cspan address=\"10.5858/arpa.2020-0661-RA\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eHanafy AK, Morani AC, Menias CO, Pickhardt PJ, Shaaban AM, Mujtaba B, Mellnick VM, Elsayes KM. Hematologic malignancies of the gastrointestinal luminal tract. Abdom Radiol (NY). 2020;45:3007\u0026ndash;27. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1007/s00261-019-02278-8\u003c/span\u003e\u003cspan address=\"10.1007/s00261-019-02278-8\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eNishimura MF, Nishimura Y, Nishikori A, Yoshino T, Sato Y. Primary Gastrointestinal T-Cell Lymphoma and Indolent Lymphoproliferative Disorders: Practical Diagnostic and Treatment Approaches. Cancers (Basel). 2021;13. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.3390/cancers13225774\u003c/span\u003e\u003cspan address=\"10.3390/cancers13225774\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eShen Y, Ou J, Wang B, Wang L, Xu J, Cen X. Influence of Severe Gastrointestinal Complications in Primary Gastrointestinal Diffuse Large B-Cell Lymphoma. Cancer Manag Res. 2021;13:1041\u0026ndash;52. PMID: 33568947; PMCID: PMC7869708.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eLai Q, Zhao Y, Yan H, Peng H. Advances in diagnosis, treatment and prognostic factors of gastrointestinal DLBCL. Leuk Res. 2023;135:107406. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.leukres.2023.107406\u003c/span\u003e\u003cspan address=\"10.1016/j.leukres.2023.107406\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Epub 2023 Oct 18. PMID: 37944240.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eChen XY, Yang JY, Chen YH, Liu AN, Wu SS, Ji Zhi SN, Zheng SM. Primary duodenal T/histiocyte-rich large B-cell lymphoma complicated with obstructive jaundice: A case report and review of literature. World J Gastrointest Surg. 2025;17(1):99758. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.4240/wjgs.v17.i1.99758\u003c/span\u003e\u003cspan address=\"10.4240/wjgs.v17.i1.99758\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. PMID: 39872781; PMCID: PMC11757195.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eFilip PV, Vladareanu AM, Diaconu LS, Cuciureanu D, Tomescu A, Pop CS. Primary Gastrointestinal Lymphoma: A Prospective Unicentric Study on a Romanian Cohort. J Gastrointestin Liver Dis. 2025;34(1):23\u0026ndash;29. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.15403/jgld-6005\u003c/span\u003e\u003cspan address=\"10.15403/jgld-6005\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. PMID: 40117560.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eKim DH, Lee D, Kim JW, Huh J, Park SH, Ha HK, Suh C, Yoon SM, Kim KJ, Choi KD, Ye BD, Byeon JS, Song HJ, Jung HY, Yang SK, Kim JH, Myung SJ. Endoscopic and clinical analysis of primary T-cell lymphoma of the gastrointestinal tract according to pathological subtype. J Gastroenterol Hepatol. 2014;29(5):934\u0026thinsp;\u0026ndash;\u0026thinsp;43. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1111/jgh.12471\u003c/span\u003e\u003cspan address=\"10.1111/jgh.12471\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. PMID: 24325295.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eCatena F, De Simone B, Coccolini F, Di Saverio S, Sartelli M, Ansaloni L. Bowel obstruction: a narrative review for all physicians. World J Emerg Surg. 2019;14:20. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1186/s13017-019-0240-7\u003c/span\u003e\u003cspan address=\"10.1186/s13017-019-0240-7\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eVaidya R, Habermann TM, Donohue JH, Ristow KM, Maurer MJ, Macon WR, Colgan JP, Inwards DJ, Ansell SM, Porrata LF, Micallef IN, Johnston PB, Markovic SN, Thompson CA, Nowakowski GS, Witzig TE. Bowel perforation in intestinal lymphoma: incidence and clinical features. Ann Oncol. 2013;24(9):2439\u0026ndash;43. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1093/annonc/mdt188\u003c/span\u003e\u003cspan address=\"10.1093/annonc/mdt188\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Epub 2013 May 22. PMID: 23704194; PMCID: PMC3755328.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMoayyedi P, Eikelboom JW, Bosch J, Connolly SJ, Dyal L, Shestakovska O, Leong D, Anand SS, St\u0026ouml;rk S, Branch KRH, Bhatt DL, Verhamme PB, O'Donnell M, Maggioni AP, Lonn EM, Piegas LS, Ertl G, Keltai M, Cook Bruns N, Muehlhofer E, Dagenais GR, Kim JH, Hori M, Steg PG, Hart RG, Diaz R, Alings M, Widimsky P, Avezum A, Probstfield J, Zhu J, Liang Y, Lopez-Jaramillo P, Kakkar A, Parkhomenko AN, Ryden L, Pogosova N, Dans A, Lanas F, Commerford PJ, Torp-Pedersen C, Guzik T, Vinereanu D, Tonkin AM, Lewis BS, Felix C, Yusoff K, Metsarinne K, Fox KAA. Yusuf S COMPASS Investigators. Pantoprazole to Prevent Gastroduodenal Events in Patients Receiving Rivaroxaban and/or Aspirin in a Randomized, Double-Blind, Placebo-Controlled Trial. Gastroenterology. 2019;157:403\u0026ndash;e4125. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1053/j.gastro.2019.04.041\u003c/span\u003e\u003cspan address=\"10.1053/j.gastro.2019.04.041\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eBarbaryan A, Ali AM, Kwatra SG, Saba R, Prueksaritanond S, Hussain N, Mirrakhimov AE, Vladimirskiy N, Zdunek T, Gilman AD. Primary diffuse large B-cell lymphoma of the ascending colon. Rare Tumors. 2013;5(2):85\u0026ndash;8. PMID: 23888223; PMCID: PMC3719118.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eModemann F, Ahmadi P, von Kroge PH, Weidemann S, Bokemeyer C, Dierlamm J, Fiedler W, Ghandili S. The prognostic impact of lymphoma perforation in patients with primary gastrointestinal lymphoma - a single-center analysis. Leuk Lymphoma. 2023 Nov-Dec;64(11):1801\u0026ndash;10. Epub 2023 Aug 8. PMID: 37552203.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eLi JZ, Tao J, Ruan DY, Yang YD, Zhan YS, Wang X, Chen Y, Kuang SC, Shao CK, Wu B. Primary duodenal NK/T-cell lymphoma with massive bleeding: A case report. World J Clin Oncol. 2012;3(6):92\u0026ndash;7. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.5306/wjco.v3.i6.92\u003c/span\u003e\u003cspan address=\"10.5306/wjco.v3.i6.92\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. PMID: 22724088; PMCID: PMC3380103.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eChiang SW, Chiang TW. Colo-enteric fistula associated with diffuse large B cell lymphoma that resulted in gastrointestinal bleeding: A case report and literature review. Int J Surg Case Rep. 2022;91:106798. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.ijscr.2022.106798\u003c/span\u003e\u003cspan address=\"10.1016/j.ijscr.2022.106798\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Epub 2022 Jan 31. PMID: 35131626; PMCID: PMC8829056.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eZishan MA, Raufian K. A Delayed Presentation of Perforated Diffuse Large B Cell Lymphoma of the Small Bowel Resulting in a Large Interloop Faecaloma. Case Rep Surg. 2022;2022:3881598. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1155/2022/3881598\u003c/span\u003e\u003cspan address=\"10.1155/2022/3881598\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. PMID: 35572481; PMCID: PMC9098343.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eHong YW, Kuo IM, Liu YY, Yeh TS. The role of surgical management in primary small bowel lymphoma: A single-center experience. Eur J Surg Oncol. 2017;43(10):1886\u0026ndash;93. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.ejso.2017.06.016\u003c/span\u003e\u003cspan address=\"10.1016/j.ejso.2017.06.016\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Epub 2017 Jul 18. PMID: 28751057.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eZhuang N, Zhu Q, Li W, Wang M, Yang Q, Liu W, Li J, Yang H, Zhou W. Rare intestinal fistula caused by primary lymphoma of the gastrointestinal tract: Two case reports and literature review. Med (Baltim). 2018;97(27):e11407. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1097/MD.0000000000011407\u003c/span\u003e\u003cspan address=\"10.1097/MD.0000000000011407\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. PMID: 29979438; PMCID: PMC6076109.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003ehun HB, Baek IH, Lee MS, Kim JB, Shin SR, Kim BC, et al. Jejunocolic fistula associated with an intestinal T cell lymphoma. Gut Liver. 2011;5:387\u0026ndash;90. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.5009/gnl.2011.5.3.387\u003c/span\u003e\u003cspan address=\"10.5009/gnl.2011.5.3.387\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eNijeboer P, de Baaij LR, Visser O, Witte BI, Cillessen SA, Mulder CJ, Bouma G. Treatment response in enteropathy associated T-cell lymphoma; survival in a large multicenter cohort. Am J Hematol. 2015;90(6):493\u0026ndash;8. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1002/ajh.23992\u003c/span\u003e\u003cspan address=\"10.1002/ajh.23992\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Epub 2015 May 10. PMID: 25716069.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003ePlummer RM, Linden MA, Beckman AK. Update on B-cell lymphoproliferative disorders of the gastrointestinal tract. Semin Diagn Pathol. 2021;38(4):14\u0026ndash;20. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1053/j.semdp.2021.03.006\u003c/span\u003e\u003cspan address=\"10.1053/j.semdp.2021.03.006\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Epub 2021 Mar 26. PMID: 33863577.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eNanthakwang N, Rattarittamrong E, Rattanathammethee T, Chai-Adisaksopha C, Tantiworawit A, Norrasethada L, Ya-In C. Clinicopathological study and outcomes of primary extranodal lymphoma. Hematol Rep. 2019;11(4):8227. PMID: 31871611; PMCID: PMC6902274.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eTran QT, Nguyen Duy T, Nguyen-Tran BS, Nguyen-Thanh T, Ngo QT, Tran Thi NP, Le V, Dang-Cong T. Endoscopic and Histopathological Characteristics of Gastrointestinal Lymphoma: A Multicentric Study. Diagnostics (Basel). 2023;13(17):2767. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.3390/diagnostics13172767\u003c/span\u003e\u003cspan address=\"10.3390/diagnostics13172767\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. PMID: 37685305; PMCID: PMC10486743.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eTian FY, Wang JX, Huang G, An W, Ai LS, Wang S, Wang PZ, Yu YB, Zuo XL, Li YQ. Clinical and endoscopic features of primary small bowel lymphoma: a single-center experience from mainland China. Front Oncol. 2023;13:1142133. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.3389/fonc.2023.1142133\u003c/span\u003e\u003cspan address=\"10.3389/fonc.2023.1142133\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. PMID: 37397371; PMCID: PMC10313208.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eKim JH, Lee JH, Lee J, Oh SO, Chang DK, Rhee PL, Kim JJ, Rhee JC, Lee J, Kim WS, Ko YH. Primary NK-/T-cell lymphoma of the gastrointestinal tract: clinical characteristics and endoscopic findings. Endoscopy. 2007;39(2):156\u0026thinsp;\u0026ndash;\u0026thinsp;60. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1055/s-2006-945114\u003c/span\u003e\u003cspan address=\"10.1055/s-2006-945114\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. PMID: 17657701.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eKanno T, Katano T, Shimura T, Nishigaki R, Kojima Y, Sasaki M, Okuda Y, Sugimura N, Fukusada S, Mizuno Y, Iwasaki H, Nishie H, Tanaka M, Ozeki K, Kubota E, Tanida S, Kataoka H. Characteristic endoscopic findings of gastrointestinal malignant lymphomas other than mucosa-associated lymphoid tissue lymphoma. Acta Gastroenterol Belg 2022 Jul-Sep;85(3):477\u0026ndash;83. doi: 10.51821/85.3.9712. Epub 2022 Jun 21. PMID: 35770281.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-gastroenterology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bmge","sideBox":"Learn more about [BMC Gastroenterology](http://bmcgastroenterol.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bmge/default.aspx","title":"BMC Gastroenterology","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"primary gastrointestinal lymphomas, propensity score matching, gastrointestinal complication, gastrointestinal bleeding, gastrointestinal obstruction, gastrointestinal perforation","lastPublishedDoi":"10.21203/rs.3.rs-7621218/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7621218/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003eThis study assessed the clinical characteristics of gastrointestinal bleeding (GIB), obstruction (GIO), and perforation (GIP) in patients with primary gastrointestinal lymphomas.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eA retrospective analysis was performed of 347 patients with primary gastrointestinal lymphomas admitted to the First Affiliated Hospital of Xi\u0026rsquo;an Jiaotong University Between January 2014 and January 2024. The clinical characteristics of GIB, GIO, and GIP were recorded. This study employed propensity score matching (PSM) to identify risk factors for gastrointestinal complications (GICs).\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eIn our study of primary gastrointestinal lymphoma cohort, GICs occurred in 34.0% of patients. In our study, GIB occurred in 75 cases (21.6%), GIO occurred in 45 cases (12.9%) and GIP occurred in 28 cases (8.0%). PSM analysis indicated that decreased hemoglobin (112.57\u0026thinsp;\u0026plusmn;\u0026thinsp;19.95 vs. 100.24\u0026thinsp;\u0026plusmn;\u0026thinsp;23.20, P\u0026thinsp;=\u0026thinsp;0.041) and LDH (272.00, 189.00-399.00 vs. 188.00, 166.00-230.90, P\u0026thinsp;=\u0026thinsp;0.011) levels, as well as the presence of stomachache (P\u0026thinsp;=\u0026thinsp;0.027) are high-risk factors for the development of GIB. Stomachache (28 [62.2%] vs. 37 [82.2%], P\u0026thinsp;=\u0026thinsp;0.034), vomiting (12 [26.7%] vs. 21 [46.6%], P\u0026thinsp;=\u0026thinsp;0.031), and endoscopic evidence of hyperplastic lesions (P\u0026thinsp;=\u0026thinsp;0.022) are identified as high-risk factors for GIO. Moreover, patients with endoscopic findings of ulcerative lesions (4 [14.2%] vs. 12 [42.9%]), decreased hemoglobin levels (119.5\u0026thinsp;\u0026plusmn;\u0026thinsp;22.32 vs. 102.79\u0026thinsp;\u0026plusmn;\u0026thinsp;25.50, P\u0026thinsp;=\u0026thinsp;0.012), stomachache (16 [57.1%] vs. 23 [82.1%], P\u0026thinsp;=\u0026thinsp;0.048), and constipation (8 [28.6%] vs. 3 [10.7%], P\u0026thinsp;=\u0026thinsp;0.043) are more likely to experience GIP.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e\u003cp\u003eThis study attempted to identify risk factors for GIB, GIO, and GIP in patients with primary gastrointestinal lymphoma through PSM analysis.\u003c/p\u003e","manuscriptTitle":"The risk of digestive tract complications in patients with gastrointestinal lymphoma: A propensity score study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-12-01 07:03:42","doi":"10.21203/rs.3.rs-7621218/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2026-01-13T10:40:07+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-01-12T10:34:27+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"44385674936703306337581638693042836532","date":"2026-01-04T07:12:49+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"322821812448471417233086346032531439224","date":"2025-12-24T21:59:40+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-12-08T16:14:40+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"337730811848995721774738486120897308525","date":"2025-12-08T14:19:08+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-11-26T09:48:07+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-11-25T07:41:57+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-09-25T05:21:39+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-09-24T09:04:55+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Gastroenterology","date":"2025-09-24T09:01:25+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-gastroenterology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bmge","sideBox":"Learn more about [BMC Gastroenterology](http://bmcgastroenterol.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bmge/default.aspx","title":"BMC Gastroenterology","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"c1f9087b-0ac9-4b34-8109-9e2a1f6f8809","owner":[],"postedDate":"December 1st, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2026-03-09T16:05:03+00:00","versionOfRecord":{"articleIdentity":"rs-7621218","link":"https://doi.org/10.1186/s12876-026-04666-z","journal":{"identity":"bmc-gastroenterology","isVorOnly":false,"title":"BMC Gastroenterology"},"publishedOn":"2026-03-03 15:59:38","publishedOnDateReadable":"March 3rd, 2026"},"versionCreatedAt":"2025-12-01 07:03:42","video":"","vorDoi":"10.1186/s12876-026-04666-z","vorDoiUrl":"https://doi.org/10.1186/s12876-026-04666-z","workflowStages":[]},"version":"v1","identity":"rs-7621218","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7621218","identity":"rs-7621218","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}