原发性胃淋巴瘤200例临床分析

目的 探讨原发性胃淋巴瘤（PGL）的诊断、治疗及预后.方法 回顾性分析1990年12月至2010年12月间天津市肿瘤医院收治的200例PGL患者的临床资料.结果 200例原发性胃淋巴瘤患者中男110例,女90例,年龄19～80（中位年龄为54）岁.临床表现及实验室检查缺乏特异性,治疗前确诊130例,另70例分别误诊为胃癌（59例）、胃溃疡（5例）和慢性胃炎（6例）.行单纯化疗24例,单纯手术治疗29例,综合治疗（化疗加手术）132例患者,另有15例患者未经任何治疗.本组200例患者均接受了1～246（中位时间26）个月的随访,1、3、5及10年生存率分别为65.0％、57.5％、56.2％和55.0％.单因素和多因素预后分析结果显示,消瘦（P＜0.01）、肿瘤部位（P＜0.05）、治疗方法（P＜0.0l）、病理类型（P＜0.05）及肿瘤分期（P＜0.01）是影响PGL患者生存的独立因素.结论 PGL的漏诊率和误诊率较高,治疗应首先考虑以手术为主的综合治疗.

Clinical analysis of 200 patients with primary gastric lymphoma

Objective To study the clinical diagnosis,treatment and prognosis of primary gastric lymphoma （PGL）.Methods Clinical data of 200 patients with PGL who were treated at the Tianjin Cancer Hospital were retrospectively reviewed.Results There were 110 males and 90 females.The age ranged between 19 and 80 （median,54） years old.Symptoms or laboratory examinations were not specific.Before the treatment, 130 cases were diagnosed correctly,and the remaining 70 were misdiagnosed as gastric cancer （n=59）,gastric ulcer （n=5） and chronic gastritis （n=6）.Twenty-four cases received chemotherapy alone, 29 cases surgery alone, 132 cases underwent surgery plus chemotherapy,and 15 were not treated.The 200 cases all received follow-up ranging from 1 to 246 months（median,26 months）.The 1,3,5,and 10-year survival rates were 65.0%,57.5%,56.2%,and 55.0%.Univariate analysis and multivariate analysis showed that emaciation （P〈0.01）,tumor location（P〈0.01 ）,treatment modality（P〈0.01 ）,histological type （P〈0.05）,and tumor staging（P〈0.05） were independent factors of survival in patients with PGL.Conclusions The misdiagnosis of PGL is very frequent.The treatment of choice should be comprehensive therapy based on surgery.