原发性胃肠道恶性淋巴瘤诊治探讨

目的：探讨原发胃肠道恶性淋巴瘤的临床特征、术前提高诊断率的有效措施、最佳手术方式及术中注意事项与术后综合治疗方案。方法：对34例PGIML进行回顾性分析并结合有关文献对PGIML诊话进行探讨。结果：PGIML术前漏误诊率迭85.8％92.3％，全组均行手术治疗，大部分术后行化(放)疗，单纯手术组3年、5年生存率分别为30.0％和10.0％，明显差于手术加化(放)疗组的72.7％和63.7％。结论：PGIML术前应采用内镜、X线、CT、分子生物学等各种手段明确诊断。治疗不应单纯手术，术后应辅以化疗和(或)放疗以提高长期存活率。

The Diagnosis and Treatment of Primary Gastrointestinal Malignant Lymphoma

Objective:To investigate the clinical features of primary gastrointestinal malignant lymphoma,the effective measures of improving the rate of diagnosing before operation,the best operating methods,points for attention during the course of operation and the synthtical treatment after the operation.Methods:34 cases of PGIML were reviewed and analysed,then studing the diagnosis and treatment of primary gastrointestinal malignant lymphoma referring to some relevant documents.Results:The rate of the failure and mistake in diagnosing PGIML before operation reached 85.8 % to 92.3 %, All were treated by operations. Most were treated by chemotherapeutics (or radiotherapeutics) after operations. The patients could live. 3 to 5 years if only by operations. The possibility of surviving was respectively 30.0 % and 10.0 %. They are clearly worse than the way of opertion together with chemotherapeutics (or radiotherapeutics), of which the rate of survival is 72.7 % and 63.7 %.Conclusion:Various effective methods of diagnosing PGIML should be used,such as endoscopy,X ray,CT,moleular biology,etc.Not only should operations be used in treatment,but also chemotherapeutics (or radiotherapeutics) should be used after operations to raise the proportion of long term survival.