原发性胃肠道非霍奇金淋巴瘤38例分析

目的　探讨原发性胃肠道非霍奇金淋巴瘤 (PGI-NHL)的诊断及治疗。方法　分析了本院 1993年 2月至 2 0 0 1年 2月收治的38例资料完整的原发性胃肠道非霍奇金淋巴瘤的临床表现、X线及内镜下特征以及治疗。所有病例均手术切除或剖腹探查 ,术后辅助放疗、化疗。结果　原发性胃肠道非霍奇金淋巴瘤的临床表现缺乏特异性 ,X线误诊率高 ,其中原发性胃淋巴瘤误诊率达82 .6 %,肠淋巴瘤误诊率达 10 0 %。原发性胃淋巴瘤第一次胃镜确诊率仅 47.8%,辅助化疗周期数与生存时间呈正相关。结论　对于有消化道症状而X线及胃镜检查不能明确诊断者应高度警惕原发性胃淋巴瘤可能 ,并能通过胃镜多点活检确诊 ,确诊后首选手术治疗 ,术后辅助化疗放疗能提高生存率。

Analysis of 38 Cases with Primary Gastrointestinal Non-Hodgkin''''s Lymphoma

Objective To explore the diagnosis and treatment of primary gastrointestinal non-Hodgkin's lymphoma (PGI-NHL).Methods 38 cases of PGI-L (from February, 1993 to February, 2001) were analyzed in clinical feature, X-ray films and endoscopy among them. All the cases had been operated or given exploratory laparotomy ,And after that , the adjuvant chemotherapy or radiotherapy were given.Results The clinical symptom of PG-L was short of idiocrasy, misdiagnosis rate of X-ray films were high. Among these cases, misdiagnosis rate of PG-L was 82.6%, misdiagnosis rate of intestinal lymphoma was 100%, confirmed diagnosis rate of endoscopy of first time was only 47.8%, the numbers of period of adjuvant chemotherapy were positively related to survival period.Conclusions The cases which had symptom of digestive canal and which can't be diagnosed by X-ray films and endoscopy should be conceived in PGI-L. Multi-point biopsy and deep biopsy can improve confirmed diagnosis rate, and operation should be the first treatment for PGI-L. Adjuvant chemotherapy and radiotherapy can receive better survival.