胃黏膜相关淋巴样组织瘤与幽门螺杆菌感染的相关性研究  

Helicobacter pylori infection and gastric mucosa associated lymphoid tissue lymphoma

作　　者：盛剑秋[1] 李世荣[1] 王鲁平[2] 皋兰香 赵晓军[1] 田玉旺[2] 邓永江[2] 

机构地区：[1]北京军区总医院消化科,100070 [2]北京军区总医院病理科,100070

出　　处：《中华消化杂志》2002年第6期354-356,共3页Chinese Journal of Digestion

摘　　要：目的　回顾分析胃黏膜相关淋巴组织 (MALT)瘤与幽门螺杆菌 (Hp)感染的相关性。 方法　收集手术和病理确诊的消化道原发性非霍奇金淋巴瘤 35例 ,行常规病理和免疫组化染色 (CD3 ,CD5,CD10 ,CD2 0 ,CD2 3 ,CD45RO ,Kappa,Lamda ,Cyclin1,Ki6 7,TUNEL)重新作出病理学评价。同时观察Hp感染情况。 结果　①MALT瘤共 2 1例 ,其中胃MALT瘤 16例 ,小肠 1例 ,结肠 4例。②胃MALT瘤中 ,除 3例因切片均为癌组织无法判定有无Hp感染以外 ,余 13例Hp均为阳性。③胃MALT瘤中 ,Ⅰ1期 2例 ,Ⅱ1期 5例 ,ⅡE 期 9例。④内镜误判为胃癌者 3例 ,误判为巨大肥厚性胃炎者 1例 ,误判为萎缩性胃炎者 1例 ,诊断为慢性胃炎者 5例 ,6例患者系胃镜活检确诊。⑤ 1例经 3个疗程抗Hp治疗 ,病变完全消退 ,Hp转阴 ,经内镜及病理检查随访 3年未见复发。 结论　①胃MALT瘤与Hp感染关系密切。②抗Hp治疗可治愈早期MALT瘤。Objective To study the relationship between gastric mucosa associated lymphoid tissue (MALT) lymphoma and Helicobacter pylori (H.pyori) infection retrospectively. Methods The paraffin embedded samples of the tumors in gastric intestinal tract and its corresponding normal tissues from 35 patients with non Hondgkin's lymphomas in gastric intestinal tract were sectioned. The slides, except routine histopathologic study, were submitted to immuno histochemical staining (CD 3,CD 5,CD 10 ,CD 20 ,C 23 ,CD 45 RO, kappa, lamda, cyclin, Ki67, TUNEL) and to HE staining for the detection of H. pylori infection. Results ①Twenty one cases were identified to be MALT lymphomas according to the results of immunohistochemical staining, of them 16 cases were gastric MALT lymphomas, 1 case of intestinal MALT lymphoma, and 4 cases of colonic MALT lymphomas. ② H. pylori infection in gastric MALT lymphoma was 100% except in 3 cases who had only tumor tissues, which could not be evaluated. ③ Two cases were stage Ⅰ 1 gastric MALT lymphomas, 5 were stage Ⅱ 1,and 9 were stage Ⅱ E. ④ Only 6 cases had recognized as gastric MALT lymphomas by endoscopy and biopsy. Three patients were misdiagnosed as gastric cancer, 1 as Ménétrier disease, 1 as atrophic gastritis, and 5 as chronic gastritis endoscopiclly. ⑤ One patient got a complete regression after 3 courses of anti H. pylori therapy and was in good health after 3 years of the treatment. Conclusions ① A close relation was present between H.pyloi infection and gastric MALT lymphoma. ② Early gastric MALT lymphoma may regress after eradication of H.pylori.

关 键 词：胃黏膜相关淋巴样组织瘤 幽门螺杆菌感染 相关性研究 免疫组织化学 

分 类 号：R735.2[医药卫生—肿瘤]