原发性胃淋巴瘤内镜下表现及分析

Endoscopic patterns and analysis of primary gastric lymphoma

目的探讨原发性胃淋巴瘤的内镜下特点并进行分析,以期提高内镜对原发性胃淋巴瘤的诊断率。方法收集近4年我院通过内镜活检确诊的原发性胃淋巴瘤17例和内镜拟诊的原发性胃淋巴瘤20例,分析其内镜下特点。结果17例确诊的原发性胃淋巴瘤绝大部分为弥漫性大B细胞淋巴瘤,内镜下特点主要为病变大、范围广、以胃体为主的多部位侵犯,表现为大的溃疡(10/17,58.8%)、广泛的小结节或小息肉样病变可形成鹅卵石样外观(4/17,23.5%)。20例疑诊原发性胃淋巴瘤组内镜下表现为以胃窦为主的相对较小的溃疡型(5/20,25.0%)和较大结节样增生隆起性病变的结节型(9/20,45.0%)。二者内镜下病变形态差异有统计学意义(P<0.01),而在病变的蠕动性及活检质地方面差异无统计学意义(P>0.05)。结论原发性胃淋巴瘤内镜下形态具有多型性,呈现一定的内镜特征,提高对其内镜下表现的认识并结合深取活检对原发性胃淋巴瘤的内镜确诊具有重要意义。

Objective To improve the diagnosis level of primary gastric lymphoma by observing and analyzing the endoscopic manifestation. Methods A total of 17 primary gastric lymphoma diagnosed by endoscopic biopsy and 20 pseudo-diagnosed ＂lymphoma＂ by endoscopy were included in this study. Enumerative data were analyzed with exact probabilities. Results The most common primary gastric lymphoma was of diffuse large B-cell lymphoma. Its endoscopic patterns were mainly ulcer type （ 10/17, 58.8% ） and nodus type （ 4/17,23.5% ）, which usually displayed large and extensive lesion in stomach body. There was significant difference in endoscopic patterns between two groups （ P 〈0.01）. However, there was no significance in movements and texture （ P 〉 0.05）. Conclusion Endoscopic patterns of primary gastric lymphoma present polymorphism and certain feature. It is important to distinguish its endoscopic presentation and combine with deep and multi-spot biopsy.