CAJ | 학술논문

目的探讨原发性胃淋巴瘤的临床特点和治疗方法.方法回顾性分析23例经病理证实为原发性胃淋巴瘤患者的临床资料.23例均行手术治疗,其中胃大部切除16例(D1 9例,D2 7例),全胃切除3例,姑息性切除术2例,剖腹探查术2例.术后21例患者接受辅助化疗.结果本组总体5年生存率为80%.低度恶性14例,其巾病史5年以上有10例,生存期超过5年9例;高度恶性9例,病史5年以上有7例(失访2例),生存期超过5年2例.Ⅰ期13例,病史5年以上有10例,生存期超过5年9例;Ⅱ期7例,病史5年以上有5例(失访2例),生存期超过5年2例;Ⅲ～Ⅳ期3例,5年生存0例.根治性手术19例中病史5年以上有14例(失访1例),生存期超过5年12例;非根治性手术4例(失访2例),5年生存0例.低度恶性、早期并获得根治性切除的原发性胃淋巴瘤预后较好.结论原发性胃淋巴瘤的术前诊断和分期主要依靠胃镜和CT检查.手术和术后辅助治疗是治疗早期原发性胃淋巴瘤的重要手段,非手术疗法是治疗晚期原发性胃淋巴瘤的主要方法.
목적 탐토원발성위림파류적림상특점화치료방법.방법 회고성분석23례경병리증실위원발성위림파류환자적림상자료.23례균행수술치료,기중위대부절제16례(D1 9례,D2 7례),전위절제3례,고식성절제술2례,부복탐사술2례.술후21례환자접수보조화료.결과 본조총체5년생존솔위80%.저도악성14례,기건병사5년이상유10례,생존기초과5년9례;고도악성9례,병사5년이상유7례(실방2례),생존기초과5년2례.Ⅰ기13례,병사5년이상유10례,생존기초과5년9례;Ⅱ기7례,병사5년이상유5례(실방2례),생존기초과5년2례;Ⅲ～Ⅳ기3례,5년생존0례.근치성수술19례중병사5년이상유14례(실방1례),생존기초과5년12례;비근치성수술4례(실방2례),5년생존0례.저도악성、조기병획득근치성절제적원발성위림파류예후교호.결론 원발성위림파류적술전진단화분기주요의고위경화CT검사.수술화술후보조치료시치료조기원발성위림파류적중요수단,비수술요법시치료만기원발성위림파류적주요방법.
Objeetive To probe the clinical diagnosis and surgical treatment of primary gastric lymphoma (PGL). Methods Clinical data of 23 PGL patients identified by postoperative pathology were analyzed retrospectively. Sixteen patients underwent subtotal gastrectomy,3 patients underwent total gastrectomy,2 patients underwent palliative resection and 2 patients underwent exploratory laparotomy only. Postoperatively 21 patients received adjuvant treatment(chemotherapy and/or radiotherapy).The variables analyzed were type of surgery, histological type in accordance with Kiel's classification, Involvement of lymph nodes. Ann Arbor stage classification. Results The overall 5-year survival rate of these patients Was 80%,that of low grade malignancy patients was 90%,and of high grade malignancy was 40%.Thirteen patients were classified as stage Ⅰ E and seven as stageⅡE and three as stageⅢor Ⅳ,the 5-year survival rate was 90%,67%and 0,respectively.Nineteen patients underwent radical resection with 5-year survival rate of 92.3%.No patients undergoing palliative resection have survived more than 5 years. The prognosis of PGL with low grade malignancy and that of early stages(IE and Ⅱ E)and those undergoing radical excision was better than those with high grade malignancy, that of advanced stage(Ⅲand Ⅳ),and that undergoing palliative resection. Conclusions Preoperative diagnosis relies mainly on gastroscopy with biopsy and CT scan. For patients with early stage disease,radical resection combined with adjuvant therapy is the key factor in improving the prognosis. Chemotherapy or/and radiotherapy is useful management for patients with advanced stage disease.