原发性胃肠道恶性淋巴瘤的诊治探讨

The Clinical Diagnosis And Therapy Of Primary Gastrointestinal Malignant Lymphoma

目的 探讨原发性胃肠道恶性淋巴瘤的临床诊断及治疗方案。方法 总结通过手术及病理确诊的49例原发性胃肠道恶性淋巴瘤的临床特点和内镜资料以及病理所见。结果 原发性消化道恶性淋巴瘤病变部位较多的是胃及小肠,术前病理活检确诊率达62%。结论 内镜检查进行活检时多部位、多次活检及黏膜下取材并加以免疫组化检查有助于提高诊断率。对低度恶性并且无转移的胃黏膜相关淋巴组织淋巴瘤(MALT淋巴瘤)以根除HP作为首选,然后加以化疗或放疗。对其它类型的消化道恶性淋巴瘤,必须结合手术、化疗或放疗。

Objective To study the clinical diagnosis and therapy of primary gastrointestinalmalignant lymphoma(PGML). Methods Forty-nine cases of primary gastrointestinal malignant lymphomawere retrospectively studied which were diagnosed through an endoscopic biopsy or operation. ResultsThe most common site of involvement was the stomach and small bowel. Positive findings by biopsies wereattained in 62% of patients before operation. Conclusions The accuracy of diagnosis could be improvedby endoscopic biopsy from multiple sites, submucosal strips and histopathologic and immunohistochemicalanalysis. Helicobacter pylori eradication and subsequent chemotherapy or radiotherapy is recommended asfrontline treatment for low grade gastric mucosa associated lymphoid tissue lymphoma (MALTOMA). Surgeryor chemotherapy in combination with radiotherapy is an effective treatment option for other kind ofaggressive gastrointestinal lymphoma.