双重免疫标记与胃肠道粘膜相关淋巴瘤

粘膜相关淋巴组织淋巴瘤（Lympoma of mucosa-assoctated Lymphoidtissue,MATL淋巴瘤）是结外淋巴瘤中少见的一种，其中以胃肠道MATL型淋巴瘤较常见，由于瘤组织中细胞成份纷杂、反应性滤泡点缀于组织中，该瘤的诊断存在一难度，尤其是粘小组织活检，随着免疫组化技术的发展，已有可能在同一切片上标记出不同的细胞成份，为同时观察几种细胞的分布特点，相互关系提供了新的手段^[1]，本文采用双重免疫组化标记，以显示胃肠道MALT的肿瘤细胞的分布及粘膜腺体,隐窝上皮的相互关系，为胃肠道MALT淋巴瘤诊断提供一种辅助方法。     

胃肠道粘膜相关淋巴组织型结外边缘区B细胞淋巴瘤的病理分析

目的 加深对粘膜相关淋巴组织（MALT）型淋巴瘤的认识。方法 复阅胃肠道MALT型淋巴瘤30例，在HE诊断基础上做HP染色和免疫组化LCA、CD20、κ、λ、CK标记。结果 胃16例，肠14例。临床主要表现为腹胀腹痛，黑便或血便，腹部包块。病理改变以边缘区B细胞（中心细胞样细胞）为主，13例出现变异大细胞，3例以变异大细胞为主。25例有淋巴上皮（LEL)病变，18例有淋巴滤泡结构，21例见浆细胞浸润。17例HP阳性，30例CD20阳性。结论 胃肠道MALT型淋巴瘤与HP感染关系密切。低度恶性的MALT型淋巴可向中度恶性或高度恶性淋巴瘤转化。     

胃粘膜相关淋巴组织淋巴瘤临床特点分析

目的总结胃粘膜相关淋巴组织淋巴瘤(MALT)临床特征、内镜特点及治疗,提高诊断率。方法收集我院2008年12月～2012年8月收治的6例MALT淋巴瘤患者临床资料,对其临床、内镜特点、病理资料和治疗方面进行回顾性分析。结果胃MALT淋巴瘤临床表现无明显特异性,误诊率高(3/6)。以上腹痛多见(3/6),内镜下以溃疡型多见,病理类型为B细胞型淋巴瘤,治疗多行手术治疗(4/6),配合抗HP、放化疗。结论早期需提高对胃MALT淋巴瘤的认识,降低误诊率。抗HP治疗发挥重要作用。     

胃粘膜相关淋巴组织淋巴瘤7例临床分析

胃粘膜相关淋巴组织淋巴瘤（MALT）为一原发性胃恶性淋巴瘤,来源于胃粘膜相关淋巴组织,属结外型非何杰金淋巴瘤,包括低恶性B细胞淋巴瘤、伴或不伴低恶性成分的高恶性B细胞淋巴瘤^[1]。国内近年关于MALT的报告日益增多,我院自1992年以来经乒术或内窥镜检查结合病理活检证实MALT共7例,报告如下。     

原发性胃肠道黏膜相关淋巴组织淋巴瘤12例

原发性胃肠道黏膜相关淋巴组织(MALT)淋巴瘤是来源于MALT的原发性淋巴瘤,为低度恶性,临床并不常见。现将我院2000年1月至2010年12月收治的12例原发性胃肠道黏膜相关淋巴组织淋巴瘤报道如下:     

粘膜相关淋巴组织淋巴瘤二例报道附文献复习

粘膜相关组织淋巴瘤是一种起源于胃、肠、咽淋巴环、肺、甲状腺、唾液腺、泌尿生殖道等粘膜相关淋巴组织的非霍奇金B淋巴系肿瘤,占全部胃肠道恶性淋巴瘤的1％～7％,国内1989年以来共报道约90例。现将本科所见2例报道于下,并作简要文献复习。 病例介绍 例1 男,61岁。因反复发热伴左腮旁肿块,在当地医院抗感染及抗结核治疗无效,于1996年1月23日入院。体检:体温38℃,中度贫血貌。左腮后及耳前各可触及一枚肿大淋巴结,1cm×1cm大小,质     

23例胃肠粘膜相关淋巴组织淋巴瘤临床病理分析

目的 探讨胃肠粘膜相关淋巴组织（MALT）型淋巴瘤的临床病理特点，为诊断及临床治疗提供依据。方法 对23例胃肠MALT型淋巴瘤进行临床、病理形态观察和免疫组化染色研究。结果 23例胃肠MALT型淋巴瘤，男性发病高于女性，平均年龄为42．3岁，临床症状无特异性。病理学上低度恶性MALT淋巴瘤6例，高度恶性MALT淋巴瘤17例。对12例采用免疫组化染色，证实11例为B细胞性淋巴瘤，随访10例，8例生存时间超过5年。结论 胃肠MALT淋巴瘤与结内淋巴瘤不同，是一组具有独特临床病理特征的肿瘤：可能与HP感染有关，HP感染使胃形成获得性MALT并发展成MALT淋巴瘤；绝大部分为B淋巴细胞起源；预后较胃肠癌好。     

胃肠道黏膜相关淋巴组织淋巴瘤的临床与病理分析

目的分析胃肠道黏膜相关淋巴组织淋巴瘤(GIL-MALT)的临床病理特征。方法回顾性分析2011年1月至2017年12月本院收治的经病理证实的62例GIL-MALT患者的临床及病理资料,总结GIL-MALT患者的病理特征。结果肿瘤大体位置:胃部40例(64.52%),肠道22例(35.48%);病灶数量:单发病灶50例(80.65%),多发病灶12例(19.35%);病理特征:黏膜下层浸润6例(9.68%),浆膜内浸润50例(80.65%),浸润突破浆膜外6例(9.68%)。结论 GIL-MALT的临床表现无特异性,且存在多发病灶风险,极易造成漏诊、误诊,掌握其病理特点并结合内镜下多点多次活检对提高其确诊率具有十分重要的意义。     

Treatment of gastric marginal zone lymphoma of MALT type

Importance of the field: Gastric marginal zone lymphomas of mucosa-associated lymphoid tissue (MALT type) represent approximately half of all cases of lymphomas arising in the stomach. They have been strongly associated with chronic Helicobacter pylori (H. pylori) gastritis. Treatment aimed at eradicating this infection results in lymphoma remissions in the majority of patients (approximately 80%) and this represents a unique case of anticancer treatment based on the eradication of the causing factor.

Areas covered in this review: The effects of H. pylori eradication in suppressing the growth of this lymphoma with particular emphasis on the long-term disease control results are presented in this review. Trials of different treatment modalities for patients not responding to antibiotics are also covered.

What the reader will gain: Understanding of the effects of H. pylori eradication on suppressing the growth of gastric MALT lymphoma. Readers will learn how to distinguish between clinical, histological and molecular remission of the lymphoma and will learn alternative treatments for patients with H. pylori-negative disease and for cases not responding to eradication.

Take home message: Gastic MALT lymphoma has an indolent course and most patients can achieve durable disease control after only anti-H. pylori therapy. For patients not responding to antibiotics, randomized trials are needed to define the best treatment modality.     

The treatment of Helicobacter pylori infection: the changing picture of a still unresolved problem

More than 20 years from the discovery of Helicobacter pylori there is still a need to eradicate the bacterium. The efficacy of the current preferred first-line therapy – the triple regimen – has progressively decreased over the last 5 – 6 years, paralleling the progressive increase in the prevalence of resistant bacterial strains. Similarly, the quadruple therapy has progressively lost its importance as rescue therapy in some countries where bismuth is no longer available. A large number of studies investigating new combinations of drugs, new antibiotics and new regimens have been published in recent years. The most promising regimens – sequential therapy and triple therapy with lovofloxacin – have progressively gained importance but still need further confirmation of their efficacy before they can replace the old protocols in the everyday treatment of H. pylori infection.     

糖皮质激素前体药在大鼠胃肠道中定位转释的药代动力学

目的探讨以葡聚糖(平均分子量26万)为载体的地塞米松前体药在大鼠胃肠道内的转释特性。方法前体药按5μmol·kg^-1地塞米松(Dex)给大鼠ig,采用HPLC监测前体药在大鼠胃肠道不同部位释放出Dex的动力学过程及血药浓度。结果前体药ig后,Dex集中分布在盲肠和结肠内容物及粘膜中,C_peak为32μg·L^-1;Dexig后,主要分布在胃、小肠近端及远端内容物和粘膜中,C_peak为2120μg·L^-1。结论该前体药可将Dex特异地转运到结肠和盲肠,是一种治疗炎症性肠病的潜在药物。     

Eradication of 'ooHelicobacter pylori'ox : an objective assessment of current therapies

The purpose of the present review was to determine objectively the optimal treatment for the eradication of H. pylori amongst the currently used regimens. A comprehensive literature search provided a data-base relating to the following treatments: dual therapy with an anti-secretory drug plus either amoxycillin or clarithromycin; standard triple therapy, with or without additional anti-secretory drugs; proton pump inhibitor triple therapy; and H₂-receptor antagonist triple therapy. Emphasis was placed on intention-to-treat analyses of eradication rates using all of the available evidence. The criteria used to select the optimal treatment were efficacy (eradication rates), frequency of side-effects, simplicity of the regimen (number of tablets per day and duration of treatment) and cost. The analysis showed that proton pump inhibitor triple therapy (that is, a proton pump inhibitor plus any two of amoxycillin, clarithromycin or a nitroimidazole) was the preferred treatment for the eradication of H. pylori . In particular, the 1-week, low-dose regimen with omeprazole plus clarithromycin plus tinidazole produced the highest eradication rates (>90%) with the lowest frequency of side-effects and at only modest cost.     

H. pylori相关胃MALT淋巴瘤患者胃黏膜中β防御素-2的表达研究

目的研究人β防御素-2（HBD-2）在幽门螺杆菌（H. pylori）相关胃黏膜相关淋巴组织（MALT）淋巴瘤患者胃黏膜中的表达情况,探讨HBD-2在胃MALT淋巴瘤中的作用。方法收集40例在根除治疗前H. pylori（+）且根除治疗后H. pylori为（-）的胃MALT淋巴瘤患者的胃黏膜组织作为HP组,同时收集36例H. pylori（-）的慢性浅表性胃炎患者胃黏膜组织作为对照组,用免疫组化法检测HBD-2的表达情况。结果 HBD-2在H. pylori相关胃MALT淋巴瘤中的表达水平高于对照组（P＜0.01）;根除H. pylori治疗后,HP组HBD-2表达水平降低（P＜0.01）;且HBD-2在H. pylori相关胃MALT淋巴瘤间质细胞的表达水平高于淋巴瘤细胞（P＜0.01）;HBD-2在淋巴瘤细胞中无表达。结论 HBD-2可能参与了H. pylori相关胃MALT淋巴瘤的发病过程;但是否具有抗肿瘤作用尚不明确。     

阿霉素在恶性淋巴瘤患者体内的药代动力学研究

目的 :了解恶性淋巴瘤患者阿霉素血药浓度和药代动力学特点及其临床意义。方法 :2 6例恶性淋巴瘤患者均采用CHOP方案化疗。血药浓度测定用HPLC法。结果 :化疗有效 (CR PR) 18例 ( 6 9.2 % ) ,无效 8例( 30 .8% )。化疗有效组与无效组的平均血药峰浓度分别为 196 5 .3ng·ml-1和 1177.8ng·ml-1,K12 分别为 2 .6 2 1h-1和 1.76 1h-1,Vc分别为 5 2 6L·m-2 和 8.34L·m-2 ,差异均具有显著性 (P <0 .0 5 )。不同个体间血药浓度和药代动力学差异很大 ,变异系数 36 .5 %～ 75 .8%。结论 :恶性淋巴瘤患者阿霉素血药浓度测定及药代参数分析对预测疗效 ,实行个体化给药方案有一定的临床指导意义