原发性胃恶性淋巴瘤14例胃镜表现及临床分析

Endoscopic features and clinical analysis of primary gastric malignant lymphoma:A report of 14 cases

目的:探讨原发性胃恶性淋巴瘤的胃镜下表现及临床诊断和治疗。方法:回顾性分析1995年至2009年14例原发性胃恶性淋巴瘤患者的临床资料及胃镜下表现。结果:胃恶性淋巴瘤男5例,女9例,平均年龄54岁,胃镜下表现肿块型2例,溃疡型7例,浸润型2例,结节型3例。霍奇金病1例,非霍奇金病13例,其中12例为B细胞来源,1例为T细胞来源。手术治疗患者中2例术后1年内死亡,2年及以上生存者6例(54.5%),5年及以上生存者3例(27.3%)。2例胃黏膜相关淋巴组织淋巴瘤,给以抗幽门螺杆菌联合化学治疗。结论:原发性胃恶性淋巴瘤诊断困难,可采取普通胃镜联合病理检查等多种诊断手段综合诊断,治疗还需进一步随访观察。

Objective To investigate the endoscopic features of primary gastric malignant lymphoma（PLML） and its clinical diagnosis and therapy.Methods The clinical data and endoscopic phenotype in 14 cases of PLML from 1995 to 2009 were retrospectively analyzed.Results In the 14 cases,5 were male and 9 were female.The median age was 54.Classification by type,2 were mass,7 were ulcer,2 were infiltration,and 3 were nodule.Among them,one patient was Hodgkin＇s disease and 13 were non-Hodgkin＇s disease（12 cases were B cell source and 1 was T cell source）.Ten patients were conducted the surgery.The 2-year survival rate was 54.5%,and the 5-year survival rate was 27.3%.Two patients with mucosa associated lymphoid tissue（MALT） lymphoma were treated by anti Helicobacter pylori（HP） and chemical therapy.Conclusion Primary gastric malignant lymphoma is difficult to diagnose.Its diagnosis can be improved by the combination of gastroscope and pathology.The therapeutic effect needs to be monitored by the follow-up observation.