胃黏膜相关淋巴样组织淋巴瘤的内镜特征和临床病理分析  

Endoscopic Features and Clinical Pathology Analysis of Gastric Mucosa-associated Lymphoid Tissue Lymphoma

作　　者：吴玉娇 江月萍[1] 巩芮宁 王小玮[1] WU Yujiao;JIANG Yueping;GONG Ruining;WANG Xiaowei(Department of Gastroenterology, the Affiliated Hospital of Qingdao University, Qingdao, Shandong Province 266000)

机构地区：[1]青岛大学附属医院消化内科,266000

出　　处：《胃肠病学》2020年第6期344-347,共4页Chinese Journal of Gastroenterology

摘　　要：背景:胃黏膜相关淋巴样组织(MALT)淋巴瘤是一种少见的结外B细胞淋巴瘤,其临床症状不典型,内镜下表现多样,诊断具有一定的挑战性。目的:总结胃MALT淋巴瘤的临床病理特征和内镜下表现。方法:回顾性分析2013年1月—2018年12月青岛大学附属医院经病理确诊的33例胃MALT淋巴瘤患者的临床病理资料,总结其临床病理特征和内镜下表现。结果:胃MALT淋巴瘤的男性发病率略高于女性,平均发病年龄约为54岁;幽门螺杆菌(Hp)感染率为81.8%;临床表现以上腹部疼痛(48.5%)为主;病变多累及胃体;内镜下形态以溃疡型为主。胃MALT淋巴瘤早期(Ⅰ+Ⅱ)患者26例,晚期(Ⅲ+Ⅳ)患者7例,早期组Ki-67增殖指数显著低于晚期组(P<0.05),而两组年龄、性别、Hp感染、病变部位相比差异均无统计学意义(P>0.05)。结论:胃MALT淋巴瘤临床表现不典型,内镜下表现多样。内镜检查结合组织病理学检查为确诊依据,定期内镜随访对患者预后十分重要。Background:Gastric mucosa-associated lymphoid tissue(MALT)lymphoma is a rare extranodal B cell lymphoma with atypical clinical symptoms and diverse endoscopic manifestations,and its diagnosis is a challenging.Aims:To summarize the clinicopathological features and endoscopic manifestations of gastric MALT lymphoma.Methods:Clinicopathological data of 33 patients with gastric MALT lymphoma diagnosed by pathology from Jan.2013 to Dec.2018 at the Affiliated Hospital of Qingdao University were retrospectively analyzed.The clinicopathological features and endoscopic manifestations of gastric MALT lymphoma were summarized.Results:The incidence of gastric MALT lymphoma of male was slightly higher than that of female,and the average age was 54 years old.The infection rate of Helicobacter pylori(Hp)was 81.8%.The main clinical manifestation was upper abdominal pain(48.5%).Gastric body was the main lesion site.The endoscopic morphology was dominated by ulcer type.Twenty-six patients were early gastric MALT lymphoma(Ⅰ+Ⅱ),and 7 were advanced gastric MALT lymphoma(Ⅲ+Ⅳ).Ki-67 proliferation index in early gastric MALT lymphoma was significantly lower than in advanced gastric MALT lymphoma(P<0.05),however,no significant differences in gender,age,Hp infection and lesion site were found between the two groups(P>0.05).Conclusions:The clinical manifestations of gastric MALT lymphoma are not typical,and the endoscopic manifestations are varied.Endoscopic examination combined with pathological biopsy is the basis of diagnosis.Regular endoscopic follow-up is very important for the prognosis of patients with gastric MALT lymphoma.

关 键 词：淋巴瘤 黏膜相关淋巴样组织 幽门螺杆菌 内镜检查 临床病理特征 诊断 治疗 

分 类 号：R73[医药卫生—肿瘤]