Szúcs G, Tóth I, Barna T, Nagy Z, Horváth G, Kiss J I
Miskolc Megyei Jogú Város Onkormányzata Semmelweis Kórház.
Magy Seb. 2000 Dec;53(6):253-8.
During ten years 580 patients have been treated for gastric tumour in our department, 510 of them were operated on. Resection could be performed in 296 cases. 17 resections, 5.7 per cent of all were performed because of primary non-Hodgkin gastric lymphoma. No gastric lymphoma was found among the non-resected patients. The preoperative histological diagnosis was correct only in 8 cases. MALT origin could be proved in 5 patients. Synchronous adenocarcinoma and lymphoma was diagnosed in 2 patients. Staging was decided according to Lugano classification. There were six stage I, four stage II, and seven stage IV patients. 8 subtotal and 9 total gastrectomy was performed, 5 were extended and 2 were combined. R0 resection could be carried out in five stage I, two stage II and in one stage IV patient. We lost 2 patients in the postoperative period. Patients were treated with adjuvant chemotherapy (VEP, CHOP) except for 2 patients with low grade MALT lymphoma. The likelihood of one-year survival is 73 per cent, average two-year survival is 63 per cent. When the tumour is operable by total gastrectomy we suggest to perform splenectomy as well, despite of the fact that some postoperative complications can be related to it. We think it is reasonable to perform palliative resection in cases of locally extended stage IV tumours, which affect the patient's quality of life: to cease the pain, passage troubles, bleeding and to improve the conditions for adjuvant treatment.
十年来，我科共收治580例胃肿瘤患者，其中510例行手术治疗。296例可进行切除手术。17例切除手术（占全部切除手术的5.7%）是因原发性非霍奇金胃淋巴瘤而进行的。未行切除手术的患者中未发现胃淋巴瘤。术前组织学诊断仅8例正确。5例患者可证实为黏膜相关淋巴组织起源。2例患者诊断为同步性腺癌和淋巴瘤。分期根据卢加诺分类法确定。有6例Ⅰ期、4例Ⅱ期和7例Ⅳ期患者。行8例次胃大部切除术和9例次全胃切除术，其中5例扩大切除，2例联合切除。5例Ⅰ期、2例Ⅱ期和1例Ⅳ期患者可实现R0切除。术后死亡2例。除2例低级别黏膜相关淋巴组织淋巴瘤患者外，其余患者均接受辅助化疗（VEP、CHOP）。一年生存率为73%，平均两年生存率为63%。当肿瘤可行全胃切除时，尽管可能会有一些术后并发症与之相关，我们建议同时行脾切除术。我们认为，对于局部进展的Ⅳ期肿瘤，若影响患者生活质量，如引起疼痛、排便困难、出血等，并改善辅助治疗条件，行姑息性切除是合理的。
