原发性胃恶性淋巴瘤57例诊治探讨

Diagnosis and surgical treatment of primary gastricmalignant lymphoma report of 57 cases.

本文报告１９７１～１９９３年收治的５７例原发性胃恶性淋巴瘤，其中ＩＥ期３３例、ⅡＥ期７例、ⅢＥ期３例、Ⅳ期１４例。本组术前确诊仅１２例。误诊主要原因是本病临床表现缺乏特异性，更重要的是其Ｘ线征象与胃癌或溃疡病酷似。本组手术切除率９２．２％（４７／５１）。全组５年生存率６２．７％，１０年生存率４７．６％。在ＩＥ期３３例中，８例单一手术切除，术后５年生存率５９．２％；２５例术后加用化疗和／或放疗，则术后５年生存率达９０．３％。显然切除原发灶，联合术后化疗和／或放疗是合理的。

rom 1971 to 1993, 57cases of primary gastric malignant lymphoma (PGML) were hospitalized. The incidence of PGML was 1. 3% of gastric malignancies during the same period. There were 33 cases in stage i, 7in stage i, 3 in stage, and 14 in stage IV. The preoperative diagnosis of gastric lymphoma was difficultbecause the symptoms were nonspecific and the radiologic characters were very similar to those of gastriccarcinoma and peptic ulcer disease. In this series, only12 cases (21 % ) were diagnosed preoperatively. Correctemployment of the endoscopy with biopsy would helpto improve the diagnostic rate. 54 cases (94. 7% ) hadbeen followed up for I to 22 years. The overall resection rate for PGML was 92. 2% (47/51). In the wholeseries, the 5--year and 10-year survival rates was62. 7% and 47. 6% respectively. In 33 cases with stageI, 8 cases treated with resection alone gave a 5-yearsurvival rate of 59' 2%, and the other 25 cases treatedwith resection followed by chemotherapy and/or radiotherapy had a survival rate as high as 90. 3%. It is obvious that the use of curative resection in combinationwith the Postoperative chemotherapy and/or radiotherapy to treat PGML is rational.