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目的 探讨胃肠道原发性恶性淋巴瘤的诊断与治疗。方法 回顾性分析了 46例胃肠道原发性恶性淋巴溜患者的临床资料。结果 46例原发性恶性淋巴瘤中Ⅰ、Ⅱ、Ⅲ和Ⅳ期分别为 16例、 18例、 9例和 3例。术前内镜活检确诊 12例 ,3 4例经手术与病理确诊。 43例行手术切除 ,另 3例Ⅳ期行单纯活检。术后辅助化疗 3 2例 ,放疗 +化疗 12例。 1年生存率Ⅰ～Ⅲ期为 10 0 % ,Ⅳ期 66 7% ;3年及 5年总生存率分别为72 5 %及 61 6%。结论 本病早期不易诊断 ,内镜活检及手术病理检查是确诊本病的主要方法。对Ⅰ、Ⅱ、Ⅲ期病例根治性手术切除应作为首选治疗 ,术后辅助化 (放 )疗可提高生存率。对Ⅳ期应以全身化疗 +局部放疗为主要治疗手段。
Objective To investigate the diagnosis and treatment of primary gastrointestinal malignant lymphoma. Methods The clinical data of 46 patients with primary gastrointestinal malignant lymphoma were retrospectively analyzed. Results The 46 cases of primary malignant lymphoma Ⅰ, Ⅱ, Ⅲ and Ⅳ were 16 cases, 18 cases, 9 cases and 3 cases. Preoperative endoscopic biopsy confirmed 12 cases, 34 cases were confirmed by surgery and pathology. 43 cases underwent surgical resection, and the other 3 cases underwent simple biopsy in stage IV. Postoperative adjuvant chemotherapy in 32 cases, radiotherapy + chemotherapy in 12 cases. The 1-year survival rates were 100% in stages I-III and 66.7% in stage IV. The 3-year and 5-year overall survival rates were 72.5% and 61.6%, respectively. Conclusion This disease is not easy to diagnose early, endoscopic biopsy and surgical pathology is the main method of diagnosis of the disease. For Ⅰ, Ⅱ, Ⅲ cases of radical surgical resection should be treated as the preferred treatment, postoperative adjuvant (radiotherapy) can improve the survival rate. On Ⅳ should be systemic chemotherapy + local radiotherapy as the main treatment.