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目的：探讨胃原发性恶性淋巴瘤的诊断和外科治疗方法。方法：回顾性分析我院1990～1998年收治并确诊的12例胃原发性恶性淋巴瘤患者的临床资料。结果：术前临床表现为上腹痛10例，消化道出血4例，腹部触及包块4例。术前胃镜检查11例，4例诊断为胃癌，4例诊断为胃淋巴瘤，3例示慢性胃炎，胃镜确诊率37％。12例均行手术治疗，单纯性远端胃大部切除1例，根治性远端胃大部切除6例，根治性胃全部切除2例，姑息性切除3例。术后辅以CHOP（环磷酰胺、阿霉素、长春新碱、强的松）方案化疗9例。10例术后随访3年，Ⅰ期2例均生存，Ⅱ期6例生存4例，Ⅲ期1例生存，Ⅳ期1例无生存。结论：提高胃镜活检技术是提高术前确诊率的关键。根治性手术治疗是胃原发性恶性淋巴瘤的首要选择。术中切缘须行冰冻活检以确定切除范围。不能轻易放弃切除肿物的机会。
Objective: To investigate the diagnosis and surgical treatment of primary gastric lymphoma. Methods: We retrospectively analyzed the clinical data of 12 patients with primary malignant lymphoma of the stomach admitted to our hospital from 1990 to 1998. Results: The preoperative clinical manifestations were upper abdominal pain in 10 cases, gastrointestinal hemorrhage in 4 cases, and abdomen palpation in 4 cases. Preoperative gastroscopy was performed in 11 cases, 4 cases were diagnosed as gastric cancer, 4 cases were diagnosed as gastric lymphoma, 3 cases were chronic gastritis, and the gastroscopy diagnosis rate was 37%. All the 12 patients underwent surgical treatment. One patient had a simple distal gastrectomy, six had radical distal gastrectomy, two had radical gastrectomy, and three had palliative resection. After chemotherapy, 9 cases were treated with CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) regimen. In 10 patients followed up for 3 years, 2 patients in phase I survived, 6 patients survived in phase II, 4 survived in phase III, and 1 survived in phase IV. Conclusion: Improving the gastroscope biopsy technique is the key to improve the preoperative diagnosis rate. Radical surgical treatment is the primary choice for primary malignant lymphoma of the stomach. Intraoperative margins need to be frozen biopsy to determine the extent of resection. Can not easily give up the opportunity to remove the tumor.