原发性胃恶性淋巴瘤54例胃镜与临床分析  

Endoscopic and clinical analysis of primary gastric malignant lymphoma

作　　者：温静[1] 宋捷[2] 李慧[2] 梁浩[1] 郭明洲[1] 

机构地区：[1]解放军总医院消化内科,北京100853 [2]解放军第261医院消化内科

出　　处：《胃肠病学和肝病学杂志》2010年第8期728-730,共3页Chinese Journal of Gastroenterology and Hepatology

摘　　要：目的探讨原发性胃恶性淋巴瘤(PGML)胃镜下特征及其临床特点,以提高该病的诊治水平。方法对54例经病理确诊的PGML的临床、胃镜及病理资料进行分析。结果患者有上腹不适、肿块、黑便或贫血等临床表现。胃镜下主要表现为溃疡型28例,肿块型18例,弥漫浸润型8例。病变累及胃体13例,胃窦14例,多部位者16例。病理类型均为非何杰金氏淋巴瘤,其中B淋巴细胞型50例,T淋巴细胞型2例,浆样细胞型1例,T、B双淋巴细胞型1例。15例病例行手术治疗及术后辅助化疗。41例获得随访,5年生存率为53.7%。结论原发性胃恶性淋巴瘤多属B细胞来源,并且与幽门螺杆菌感染有关。胃镜检查是术前最有诊断价值的方法之一。手术方式与胃癌相似,术后化疗与手术治疗同等重要。Objective To explore endoscopic and clinical features of primary gastric malignant lymphoma（PGML） for improving diagnosis and treatment of this disease. Methods The clinical and endoscopic features as well as histopathologic data were analyzed for 54 PGML patients. Results The clinical manifestations mainly included epigastric discomfort,abdominal mass,melena and anemia.Gastroscopic appearance mainly included ulcerative lesions for 28 cases,mass lesion for 18 cases and infiltrating lesions for 8 cases.The lesions originated from body and antrum of stomach for 13 and 14 cases,and from multifocal lesions for 16 cases.All of them were non-Hodgkin lymphoma,pathologically included 50 cases of B-lymphocyte,2 cases of T-lymphocyte and 1 case with combined T and B lymphocyte.H.pylori infection was found for 70%.Fifteen patients were resected surgically and followed chemotherapy.Forty-one patients had following up data and the 5-year survival was 53.7%. Conclusion Most primary gastric malignant lymphoma are B cell lymphomas related to H.pylori infection.Gastroscopy is the best diagnostic method.Surgical resection combined postoperative chemotherapy is effective approach.

关 键 词：原发性胃恶性淋巴瘤 非何杰金氏病 

分 类 号：R735.2[医药卫生—肿瘤]