原发性胃恶性淋巴瘤诊治分析

Diagnosis and treatment of primary gastric malignant lymphoma

目的探讨原发性胃恶性淋巴瘤的诊治方法及预后。方法对1995～2005年收治的19例原发性胃恶性淋巴瘤患者的病历资料进行分析。结果术前X线、胃镜及内镜活检确诊率分别为6．3％、10.5％、21％。全组均行手术治疗，手术切除率为89.5％。术后均辅以CHOP方案化疗。5年生存率为52％。ⅠE期、ⅡE期、ⅢE＋Ⅳ期5年生存率分别为83．3％、42．9％、25％。结论原发性胃恶性淋巴瘤发病率低，临床表现无特异性，术前诊断较困难，极易误诊为胃癌。手术切除是治疗的主要方法。手术切除率和预后均优于胃癌，临床分期是判断预后的主要因素。

Objective To investigate the treatment measures and prognosis of primary gastric malignant lymphoma（PGML）. Methods The clinical data were analysed in 19 cases of PGML admitted in from 1995 to 2005. Results The diagnostic rates of X -ray barium meal,gastroendoscopy and endoscopic biopsy before operation were 6. 3% , 10. 5% and 21% respectively. All of the 19 cases were treated surgically. The surgical removal rate was 89. 5%. Postoperative chemotherapy was conducted with CHOP regimen in all the cases. The total 5 year survival rate was 52% ,and the 5 -year survival rates in stage Ⅰ E, ⅡE, ⅢE ＋ Ⅳ were 83.3% ,42. 9% and 25% respectively. Conclusion PGML has a low incidence and no specific clinical manifestations. It is not easy to make the diagnosis before operation. Most are misdiagnosed as gastric carcinoma. The surgical resection is the major therapy and is superior in PGML to in gastric carcinoma concerning surgical removal rate and prognosis,and clinical staging is the key factor for the prognosis of PGML.