原发性胃黏膜相关淋巴组织淋巴瘤临床病理与预后分析

目的探讨原发性胃黏膜相关淋巴组织淋巴瘤的临床病理特征、治疗方法、预后影响因素等。方法分析我院与天津医科大学总医院1994年至2006年收治的41例患者的病理及临床特点、治疗方法和预后。结果患者平均发病年龄63．6岁；男女比例为1．3：1；症状以上腹不适、上腹隐痛、呕血和／或黑便为主者约占90．2％；内镜下主要表现为溃疡型肿物者约占61．0％，病变部位以胃窦小弯侧多见占78．0％；幽门螺旋杆菌阳性率为82．9％；82．9％的患者行手术切除治疗。患者平均5年生存率为51．5％，是否进行抗幽门螺旋杆菌治疗以及手术治疗方式的选择等对生存率有显著影响。结论原发性胃黏膜相关淋巴组织淋巴瘤发病以中老年人为主，男性稍多，临床症状不典型，大部分患者无明显体征，可疑患者应做胃镜及多处活检，对于中晚期患者如病情及患者身体条件允许，全胃切除术能提高生存率。

Pathological and clinical analysis of primary gastric mucosa-associated lymphoid tissue lymphoma

Objective To study the clinicopathological features and management of primary gastric mucosa-associated lymphoid tissue lymphoma.Methods Clinicopathological and therapeutic data of 41 cases of primary gastric mucosa-associated lymphoid tissue lymphoma treated in our hospital from 1994 to 2006 were investigated.Results The average age of cases was 63.6 years old with male predominance.The most common presenting symptoms of primary gastric gastric mucosa-associated lymphoid tissue lymphomas included nonspecific dyspepsia and epigastric pain.The location of lymphoma was almost in antrum and lesser curvature of stomach and there was 43.9% lesions locating in antrum in all cases.The ulcerative neoplasms were revealed in 61.0% cases using endoscopy and HP infected cases were detected in 87.8% of all patients.Most of the cases accepted operation and 37 cases were followed up post-treatment for 30 months.There were 17 deaths.Conclusion Most of the cases were the elderly male.The symptoms and signs of primary gastric mucosa-associated lymphoid tissue lymphoma were atypical.The percentage of misdiagnosis in out-patients was high (29.3%) and gastroendoscopy and multiple sites biopsy are basic examination for the patients whose diagnosis is uncertain.Total gastrectomy can improve the survival of the patients whose tumors are in advanced or late stage.