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目的探讨胃原发性恶性淋巴瘤诊治方法及预后。方法对1990~2004年收治的15例原发性胃恶性淋巴瘤进行分析。结果15例中术前经X线及胃镜检查及活检仅确诊3例,余12例误诊。全组均行手术治疗,其中行根治性胃切除术10例,全胃切除术2例,姑息性切除术3例。术后均辅以CHOP方案化疗。随访率80%,全组5年生存率50%。结论胃原发性恶性淋巴瘤发病率低,其临床表现无特异性,术前极易误诊为胃癌,手术切除是治疗的主要方法,临床分期与恶性程度是判断预后的主要因素。
Objective To investigate the diagnosis and treatment of gastric primary malignant lymphoma and its prognosis. Methods 15 cases of primary gastric malignant lymphoma who were admitted from 1990 to 2004 were analyzed. Results Of the 15 cases, only 3 cases were diagnosed by X-ray, gastroscopy and biopsy before operation, and 12 cases were misdiagnosed. All patients underwent surgical treatment, including radical gastrectomy in 10 cases, total gastrectomy in 2 cases and palliative resection in 3 cases. All patients were supplemented with CHOP chemotherapy. The follow-up rate was 80%, and the 5-year overall survival rate was 50%. Conclusion The incidence of gastric primary malignant lymphoma is low, its clinical manifestations are nonspecific. It is easily misdiagnosed as gastric cancer before surgery. Surgical resection is the main method of treatment. The clinical stage and malignancy are the main factors in prognosis.