The Value Of Endoscopic Ultrasonography In Diagnosis And Follow-up Study Of Primary Gastric Lymphoma

Objective To evaluate the value of endoscopic ultrasonography(EUS) in diagnosis and follow-up study of primary gastric lymphoma(PGL) by analyzing its diagnostic accuracy and follow-up application after treatment.Methods42patients were diagnosed as PGL by gastroscopy and got EUS examination afterwards, the results were compared with biopsy and surgery pathology. We analyzed the endosonographic patterns of PGL, and compared the treatment strategies. All PGL patients were follwed-up by gastroscopy or EUS.Results33patients out of the42objects were confirmed by pathological evaluation, as to the the diagnosis of PGL, EUS had a sensitivity of90.9%and a specificity of66.7%, with an accuracy of85.7%, which was significantly higher than that of gastroscopy (85.7%VS54.5%, P<0.05, χ2=11.0). Endosonographic patterns of PGL contained local or diffused stomach wall thickening, hypoechoic lesions of homogeneity or not, extramural lymph nodes can also be scanned. Compared with the results of surgery, the accuracies of T and N staging were100%, and87.5%by EUS. The treatment protocols were chemotherapy, operation and anti-Hp therapy. The overall complete remission rate was87.9%, which occurred after a mean of4.0months. During the follow-up study, EUS combined with the endoscopic biopsy could give sufficient evidence of early relapse.Conclusions EUS has a high coincidence rate in diagnosis of PGL, its clear judgment in invasive depth and range can be crucial evidences when deciding clinical stages and therapy protocols. The patients can quickly achieve complete remission by eradicating Helicobacter pylori(Hp),EUS combined with gastrocsopy and biopsy can effectively assess the curative effect and monitor disease relapse.