原发性胃恶性淋巴瘤的外科治疗──附23例回顾性研究

SURGICAL MANAGEMENT ON23PATIENTS WITH PRIMARY GASTRIC MALIGNANT LYMPHOMA

原发性胃恶性淋巴瘤（ｐｒｉｍａｒｙｇａｓｔｒｉｃｍａｌｉｇｎａｎｔｌｙｍｐｈｏｍａ，ＰＧＭＬ）是原发于胃的淋巴网织系统的恶性肿瘤，比较少见。该病误诊率高，治疗原则也不尽一致。本文报道我院１９６８年～１９９０年手术治疗的２３例原发性胃淋巴瘤，术前误诊率为６０．９％，手术原则上同胃癌根治术。病理分期ＩＥ占６５．２％，ⅡＥ占３０．４％，ⅢＥ占４．３％。术后６５％的患者作辅助放射治疗，随访率为１００％。３年生存率为８５％，５年和１０年生存率均为８０％，效果堪称满意。作者认为术前、术中若能明确诊断，对手术有重要指导意义。手术若无法根治，也力争作胃肿瘤的姑息性切除，术后辅以放射治疗，也可望取得较好疗效。

Primary gastric malignant lymphoma,originated from gastric lymphoreticular system, isrelatively rare with various principles of treatment and high rate of misdiagnosis. From l968 to l990 23 patients with primary gastric malignant lymphoma were surgicallytreated at Cancer Hospital of Shanghai Medical University The pre- surgical misdiagnosis inthis group was 60%The surgical procedure was principally same as that of gastric cancer. Itwas IE in l5 cases(62.5%),ⅡE7(30.4%)andⅢE1(4.3%), All patients were followed up and65%patients received radiotherapy postoperatively.The survival rates of 3,5,and l0 yearswere 85%,80%and 80%,respectively.It is concluded that the pre-operative diagnosis isimportant to guidance of surgery,nd the adjuvant therapy should be adopted for inoperable ones.