内镜对原发性胃肠道黏膜相关淋巴组织淋巴瘤和弥漫性大B细胞淋巴瘤的诊断价值  

Endoscopic diagnosis for primary gastrointestinal mucosa-associated lymphoid tissue lymphoma and diffuse large B-cell lymphoma

作　　者：谷军保[1] 李晓琳 鲍学斌[1] 马钊[1] Gu Junbao;Li Xiaolin;Bao Xuebin;Ma Zhao.(Department of Gastrointestinal Surgery, He＇nan Provincial People＇s Hospital, Zhengzhou 450000, Chin)

机构地区：[1]河南省人民医院胃肠外科,郑州450000

出　　处：《中华普通外科杂志》2018年第6期493-496,共4页Chinese Journal of General Surgery

摘　　要：目的评价内镜在原发性胃肠道黏膜相关淋巴组织淋巴瘤和弥漫性大B细胞淋巴瘤诊断上的临床价值。方法对2010年8月至2017年5月河南省人民医院确诊的98例原发性胃肠道黏膜相关淋巴组织淋巴瘤和弥漫性大B细胞淋巴瘤患者的临床病理、生化、血液学及内镜诊断资料进行回顾性分析。结果98例患者中17例患者的血清LDH超过正常水平（〉270U／L），47例患者呈幽门螺旋杆菌阳性。内镜检查并进行组织活检确诊96例患者（98％），远高于LDH（17％）和幽门螺旋杆菌的检查方法（48％）。在内镜下黏膜相关淋巴组织淋巴瘤和弥漫性大B细胞淋巴瘤的病理表现为溃疡型、隆起型、浸润型和糜烂型，以溃疡型为主。黏膜相关淋巴瘤患者生存率（88％）高于弥漫性大B细胞淋巴瘤患者（68％），AnnArborI期和Ⅱ期患者的生存率（92％）高于Ⅲ期和Ⅳ期的患者（64％）。结论内镜活检技术和超声内镜技术的结合可以确诊原发性胃肠道黏膜相关淋巴组织淋巴瘤和弥漫性大B细胞淋巴瘤。Objective To evaluate endoscopy for the diagnosis of primary gastrointestinal mucosa- associated lymphoid tissue lymphoma （ MALT lymphoma） and diffuse large B-cell lymphoma （DLBCL）. Methods The clinical pathology, hematological/biochemical studies, and endoscopic data of 98 primary gastrointestinal MALT lymphoma and DLBCL patients from Aug 2010 to May 2017 were analyzed retrospectively. Results 17 patients had higher than normal LDH blood level （ 〉270 U/L）. 47 patients were Helicobacter pylori （Hp） positive; Gastrointestinal endoscopic study, including endoscopic mucosal resection （EMR）/endoscopic submucosal dissection （ESD） and endoscopic uhrasonography established diagnosis of MALT lymphoma and DLBCL in 96 out of 98 cases （98%）. The endoscopic manifestations of MALT lymphoma and DLBCL were ulcerative, uplift, diffuse and infiltrative, and erosive, with ulcerative type as the dominant one. The follow-up examination showed that the survival ratio （88%） of MALT patients was higher than that of DLBCL（68% ）, and more patients with lower Ann Arbor stage survived （92%） than those with higher Ann Arbor stage （64%）. Conclusion Endoscopic biopsy together with endoscopic uhrasonography makes definite diagnosis of MALT and DLBCL.

关 键 词：淋巴瘤 B细胞 边缘区 淋巴瘤 大B细胞 弥漫性 腔内超声检查 

分 类 号：R735[医药卫生—肿瘤]