关键词: 消化系统肿瘤, 原发性胃淋巴瘤, 胃镜检查, 内镜黏膜下剥离术, 诊断

Abstract: Objective　To investigate the role of endoscopic submucosal dissection （ESD） in the diagnosis and treatment of primary gastric lymphoma （PGL），and to improve the diagnosis and treatment for PGL.Methods　A total of 16 patients with suspected PGL who were diagnosed and treated at the Third Affiliated Hospital of Nanchang University from October 2014 to July 2017 were selected for this study.The lesions and morphologic characteristics of the patients were recorded during gastroscopy.In addition，Helicobacter pylori （HP） infections，the endoscopic specimen diagnosis rate，PGL treatment，ESD conditions，and the correct rate of endoscopy combined with multipoint deep excavation biopsy and ESD resection were noted.Results　Among the 16 patients，14 patients were treated by ESD resection，2 patients declined ESD resection and were not available for follow-up evaluations，and 12 patients were diagnosed with PGL.Among the 14 patients who were treated by ESD resection，1 had more intra-operative bleeding，but all of patients had no delayed post-operative bleeding or intra- or post-operative perforations.Of the 12 patients were diagnosed with PGL，6 patients had≥ 2 lesions，the lesions of 3 patients were limited to the corpus，the lesions of 2 patients were limited to the antrum，and the lesion of 1 patient was limited to the fundus of the stomach.There were 4 patients with superficial gastric erosions visualized during gastroscopy，4 patients had multiple ulcers，white thin coating on the surface，and visible bleeding，2 patients had enlarged stomach folds and thickening，and 2 patients had mucous prominences，multiple isolations，and erosions or ulcers on the raised surface.Eleven patients were positive for HP test.Among the 12 patients who were diagnosed with PGL，2 patients were diagnosed with PGL based on endoscopic findings，5 patients were diagnosed with PGL by undergoing gastroscopy plus multipoint deep excavation biopsy，and 11 patients were diagnosed with PGL after ESD.The diagnosis correction rate of ESD resection was higher than endoscopy combined with multipoint deep excavation biopsy （χ2=6.750，P<0.05）．Conclusion　The use of ESD resection to assist the diagnosis of PGL can increase the diagnostic correction rate and reduce the misdiagnosis rate.

Key words: Digestive system neoplasms, Primary gastric lymphoma, Gastroscopy, Endoscopic submucosal dissection, Diagnosis