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

摘要： 目的　探讨内镜黏膜下剥离术（ESD）在诊治原发性胃淋巴瘤（PGL）中的作用，以提高PGL的诊治水平。方法　选取2014年10月—2017年7月在南昌大学第三附属医院诊治的可疑PGL患者16例，记录患者胃镜下病变部位及形态特点、幽门螺杆菌（HP）感染情况、胃镜下获取标本诊断率、PGL治疗、ESD情况，比较胃镜联合多点深挖掘式活组织检查与ESD诊断正确率。结果　16例患者中，14例行ESD，2例拒绝行ESD后失访；12例确诊为PGL。14例行ESD患者中，1例术中出血较多，未发生术后迟发性出血、术中及术后穿孔。12例确诊为PGL患者中，病变部位≥2个者6例，仅局限于胃体者3例，仅局限于胃窦者2例，仅局限于胃底者1例；胃镜下胃体多发浅表糜烂者4例，多发溃疡、表面附有白色薄苔、有时可见渗血者4例，胃皱襞增大、增粗者2例，黏膜蕈状突出、多孤立存在、隆起表面有糜烂或溃疡者2例；11例HP检测结果为阳性；2例根据胃镜下表现确诊为PGL，5例行胃镜联合多点深挖掘式活组织检查确诊为PGL，11例行ESD后确诊为PGL。ESD诊断正确率高于胃镜联合多点深挖掘式活组织检查（χ2=6.750，P<0.05）。结论　采用ESD辅助诊断PGL，可提高诊断正确率，降低误诊率。

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