原发性胃恶性淋巴瘤的诊断和外科治疗

Diagnosis and Surgical Treatment of Primary Gastric Malignant Lymphoma

目的 :探讨原发性胃恶性淋巴瘤的诊断、治疗及预后问题。方法 :回顾性分析我院外科 1985年～ 2 0 0 0年期间收治 11例原发性胃恶性淋巴瘤的临床、病理及随访资料。结果 :本组病例主要症状为腹部疼痛不适、消瘦、消化道出血和腹部肿块 ,均行手术治疗 ,手术切除率为 81.2 %。病理诊断均为非霍奇金淋巴瘤。结论 :原发性胃恶性淋巴瘤发病率较低 ,其临床表现无特异性 ,X线钡餐及纤维胃镜检查的征象与胃癌或胃溃疡极难区别 ,术前极易误诊。手术切除是治疗的主要方法。临床分期与恶性程度是判断预后的主要因素 ,巨块型和浆膜累及者预后较差。

Objective: To study the diagnosis, treatment and prognosis of primary gastric malignant lymphoma. Methods: The clinical, pathologic and follow-up data were retrospectively analyzed in 11 cases with primary gastric malignant lymphoma in our hospital from 1985 to 2000. Results: In our cases, the mostly symptoms were abdominal pain, thin, gastrointestinal hemorrhage and abdominal mass. All cases were cured by operation, and the resection rate was 81.2%. All the pathological reports were non-Hodgkin's lymphoma. Conclusion: The incidence of primary gastric malignant lymphoma is low, and the clincal manifesations are lack of quality. It is difficult to differentiate the sign through gastroscopy or gastrointestinal barium X-ray between gastric cancer and gastric ulcer. Primary gastric malignant lymphoma is always misjudged before operation. The pathologic test is gold standard. Resection is the main way. TNM classification and malignant degree are main factors to judge the prognosis. The massive type and those who involves gastric serosa have worse prognsis.