放大内镜联合高频超声内镜在胃黏膜相关淋巴组织淋巴瘤诊断及复发监测中的临床应用价值  

Clinical application value of magnifying endoscopy combined with high frequency endoscopic ultrasonography in the diagnosis and recurrence monitoring of gastric mucosa-associated lymphoid tissue lymphoma

作　　者：张婷[1] 肖君[1] 周玉宏[1] 张其德[1] 韩树堂[1] Zhang Ting;Xiao Jun;Zhou Yuhong;Zhang Qide;Han Shutang(Department of Gastroenterology Endoscope,Affiliated Hospital of Nanjing University of Chinese Medicine,Jiangsu Province Hospital of Chinese Medicine,Nanjng 210029,China)

机构地区：[1]南京中医药大学附属江苏省中医院消化内镜中心,210029

出　　处：《白血病．淋巴瘤》2020年第6期346-349,共4页Journal of Leukemia & Lymphoma

摘　　要：目的探讨放大内镜联合高频超声内镜在胃黏膜相关淋巴组织淋巴瘤(GML)诊断及复发监测中的临床应用价值。方法选择2016年10月至2019年10月江苏省中医院初诊GML患者15例,对其一般情况、临床表现、Lugano分期、胃镜下表现、放大内镜下表现、高频超声内镜下表现及幽门螺杆菌感染情况进行回顾性分析,并分析疗效及随访情况。结果15例GML患者临床表现以上腹不适为主,其次为消瘦、贫血等。内镜下GML病灶多见于胃中1/3(10例),以弥漫型最常见(8例);幽门螺杆菌阳性9例;放大内镜下观察病灶处树支状血管(TLA)阳性13例,治疗后复查TLA阳性2例。高频超声内镜观察病灶可见胃壁1~3层的层次结构欠清,呈低回声改变;治疗后复查高频超声内镜,1例患者可见胃壁1~5层结构消失,病理证实由GML转变为弥漫大B细胞淋巴瘤。结论放大内镜联合高频超声内镜在GML的治疗效果评估及监测复发方面具有重要的临床应用价值;高频超声内镜可能在评估GML病情进展方面具有一定临床价值。Objective To investigate the clinical value of magnifying endoscopy and high frequency endoscopic ultrasonography(HFUS)in the diagnosis and recurrence monitoring of gastric mucosa-associated lymphoid tissue lymphoma(GML).Methods A total of 15 patients with newly diagnosed GML in the Jiangsu Province Hospital of Chinese Medicine from October 2016 to October 2019 were collected.The general data,clinical manifestations,Lugano staging,gastroscope performance,magnifying endoscopic performance,HFUS performance and helicobacter pylori infection were retrospectively analyzed.The efficacy and follow-up were also analyzed.Results The most common symptom of 15 patients with GML was upper abdominal discomfort,followed by weight loss and anemia.The frequent site of GML was the middle 1/3 of the stomach(10 cases)and the most common type was diffuse(8 cases).The positive helicobacter pylori were detected in 9 cases.The positive tree-like appearance(TLA)was found in 13 cases under magnifying endoscopy;after the treatment,2 cases had positive TLA.The unclear 1-3 layer structure of gastric wall in lesions was observed by using HFUS,accompanied with hypoechoic alteration.After the treatment,HFUS reexamination showed that the 1-5 layer structure of gastric wall disappeared in one patient,the pathological results confirmed that GML transformed into diffuse large B-cell lymphoma.Conclusion Magnifying endoscopy combined with HFUS has an important application value in therapeutic efficacy evaluation and recurrence monitoring of GML;HFUS may has a certain clinical value in the progress assessment of GML.

关 键 词：胃黏膜相关淋巴组织淋巴瘤 放大内镜 超声内镜 

分 类 号：R735.2[医药卫生—肿瘤] R445.1[医药卫生—临床医学]