胃粘膜相关淋巴组织淋巴瘤的临床探讨.doc

胃粘膜相关淋巴组织淋巴瘤的临床探讨 上海市第一人民医院分院内科 200081郑 洁 姚忆蓉 摘要 目的：探讨胃粘膜相关淋巴组织（MALT）淋巴瘤的病理特征、临床诊断和治疗。方法：收集我院1993年—2000年6例胃MALT淋巴瘤，采用胃镜、病理组织学和免疫组化标记对其临床、病理资料和治疗方面进行分析。结果：6例胃MALT淋巴瘤中，男性发病率高于女性，平均年龄54.5岁（40—77岁），临床表现和辅助检查无明显特异性，诊断有赖于病理和免疫组化，病理学上以低度恶性淋巴瘤多见，免疫组化标记证实全部为B细胞性淋巴瘤。经手术和化疗，患者均存活。结论：提高对胃MALT淋巴瘤的认识，有助于明确诊断。治疗以手术为主，配合化疗或放疗。对幽门螺旋杆菌(Hp)的治疗应引起足够的重视。 关键词 淋巴瘤、粘膜相关淋巴样组织、胃 A clinical probe of gastric mucosa-associated lymphoid tissue lymphoma. Zhengjie,Yaoyirong（Department of internal medicine, Shanghai No.1 people’s hospital branch, 200081） ABSTRACT Objective To study the pathology features, clinical diagnosis and treatments of gastric mucosa-associated lymphoid tissue (MALT) lymphoma . Methods Date of the gastric MALT lymphoma of the six cases in our hospital were collected during 1993～2000, we analyzed their clinicals, pathology materials and treatments by gastroscopy, pathology, immunohistochemistry. Results From the six cases mentioned above, we can see the morbidity in the male cases higher than that in the female ones at a ratio5:1 and at an average age54.5 years old（40-77 years old）.There had not been found any remarkable characteristics in the clinical and supplementary examination of the gastric MALT lymphoma. From pathology more cases of low grade MALT lymphoma have been found. By the way of immunohistochemistry, all the cases have been confirmed to be of B cell type MALT. Diagnosis relied on pathology and immunohistochemistry. All the patients survived after operation and chemical therapy. Conclusions To improve the understanding of the gastric MALT lymphoma is helpful to ascertain diagnosis. Operation is taken as the main in treatment complying with chemical therapy or radiotherapy. Treatment of Helicobacter pylori (Hp) should attract sufficient attention. KEY WORDS lymphoma, mucosa-associated lymphoid tissue, gastric 胃粘膜相关淋巴组织（MALT）淋巴瘤是原发性胃恶性淋巴瘤的主要类型，来源于胃粘膜相关淋巴组织。胃MALT淋巴瘤是结外型非何杰金氏淋巴瘤中最常见者，因其在组织学上常有淋巴滤泡和浆细胞出现，与淋巴细胞性胃炎、反应性淋巴细胞增生的组织学相类似较易引起误诊，现结合我院的病例对此做出以下分析