原发性胃淋巴瘤87例临床特点分析

Analysis of 87 cases of primary gastric lymphoma

目的分析原发性胃淋巴瘤的临床特点。方法回顾性分析2008年1月—2016年12月西安交通大学第一附属医院消化内科收治的87例原发性胃淋巴瘤患者临床资料,进一步分析该病的临床病理特征及辅助检查等。结果 87例患者临床表现中以腹痛最常见,占74.7%(65/87),其次为恶心、呕吐、黑便、腹部包块。低蛋白血症21例(24.1%),乳酸脱氢酶增高19例(21.8%)。胃镜检查病变部位主要位于胃窦30例(34.5%)和胃体32例(36.8%)。消化道钡餐、腹部CT、PET-CT、骨髓穿刺可以协助诊断。MALT淋巴瘤患者幽门螺杆菌阳性率为90.0%(9/10),血液乳酸脱氢酶阳性率为35.2%(19/54)。DLBCL淋巴瘤62例(71.3%),MALT淋巴瘤24例(27.6%)。治疗方法以手术、放、化疗及抗幽门螺杆菌治疗为主。结论 PGL以消化道症状为主要临床表现,胃镜检查有利于诊断,治疗手段以手术、放化疗、抗幽门螺杆菌为主。

Objective To analyze the clinical characteristics of primary gastric lymphoma. Methods The clinical data of 87 patients with primary gastric lymphoma admitted to Department of Gastroenterology, the First Affiliated Hospital of Xi＇an Jiao Tong University from January 2008 to December 2016 were retrospectively analyzed, and the clinicopathological features and auxiliary examinations of the disease were further analyzed. Results Abdominal pain was the most common in 87 patients, accounting for 74.7%（65/87）, followed by nausea, vomiting, black stool and abdominal mass. There were 21 cases （24.1%） of hypoproteinemia and 19 cases （21.8%） of lactate dehydrogenase. The site of the gastroscopy was mainly located in the gastric antrum （34.5%） and the body of the stomach （36.8%）. Barium meal of digestive tract, abdominal CT, PET CT, bone marrow puncture can help diagnosis. The positive rate of Helicobacter pylori in MALT patients was 90.0%（9/10）, and the positive rate of blood lactate dehydrogenase was 35.2%（19/54）. There were 62 cases of DLBCL lymphoma （71.3%）, and 24 cases of MALT lymphoma （27.6%）. The treatment was mainly treated by surgery, radiotherapy, chemotherapy and anti-Helicobacter pylori. Conclusion Digestive symptoms are the main clinical symptoms of PGL,gastroscopic examination is helpful for diagnosis,the main treatment methods are surgery,radiotherapy,chemotherapy and anti-helicobacter pylori.