Simultaneous occurrence of gastric adenocarcinoma and low-grade gastric lymphoma of mucosa-associated lymphoid tissue

Gastric adenocarcinoma developing concomitantly with a gastric lymphoma of the mucosa-associated lymphoid tissue (MALT) type is rare. Herein, we report a case with a synchronous primary gastric MALT lymphoma and an early adenocarcinoma of the stomach. A 72-year-old patient with initial presentation of weight loss was found with endoscopy to have a large tumor mass in the gastric body. Pathologic examination of biopsies revealed a low-grade MALT lymphoma for which chemotherapy with cyclophosphamide, vincristine, and prednisolone was administered. A gastric adenocarcinoma was found at a different site in the of stomach 3 months after cessation of chemotherapy when there was still residual MALT lymphoma in the stomach. The presence of double neoplasms was established preoperatively. The patient underwent a proximal gastrectomy. Infection with Helicobacter pylori (H. pylori) was detected once in the repeated endoscopic gastric biopsies. The occurrence of both gastric MALT lymphoma and gastric adenocarcinoma was reviewed and the association of H. pylori infection with both malignancies is discussed.     

18F-FDG PET／CT 显像对胃部恶性肿瘤的鉴别诊断价值

目的：探讨18 F‐FDG PET／CT显像对胃癌及原发性胃淋巴瘤（PGL ）的鉴别诊断价值。方法选取2012年6月至2015年6月收治的93例胃癌（23例黏液腺癌及70例非黏液腺癌）及58例PGL [31例弥漫性大B细胞淋巴瘤（DLBCL ）及27例黏膜相关组织淋巴瘤（MALT）]患者为研究对象,比较他们的临床资料、胃壁病灶的最大标准摄取值（SUVmax）、病灶最大厚度、CT值、病灶形态、合并脾肿大及肾门下淋巴结转移状况。采用Pearson相关分析SUVmax与病灶最大厚度的关系。结果胃癌组的平均年龄、病灶累及贲门的比例明显高于PGL组（P＜0．05）。胃癌组的SUVmax及脾肿大发生率均显著低于 PGL组（P＜0．05）。病灶形态方面,胃癌组以Ⅱ型及Ⅲ型多见,而PGL组以Ⅰ型及Ⅱ型多见,两组比较有显著差异（P＜0．05）。进一步分析表明DLBCL的SUVmax明显高于其他类型（P＜0．05）,病灶最大厚度明显大于胃黏液腺癌及MALT（P＜0．05）。Pearson相关分析结果表明不同病理类型患者的SUVmax与病灶最大厚度之间均无显著相关（P＞0．05）。结论18 F‐FDG PET／CT检查在胃恶性肿瘤的鉴别诊断方面有重要意义,不同肿瘤、不同病理亚型患者在SUVmax、病灶最大厚度、病灶形态等方面有所不同。     

Clinicopathological study of primary gastric lymphoma

OBJECTIVE: To present a histopathologic and immunohistochemical analysis of primary gastric lymphomas that was reclassified according to the new World Health Organization classification of lymphoid neoplasms. METHODS: We reviewed the morphological and immunohistochemical features of 28 patients with gastric lymphomas, diagnosed in the Department of Pathology at the University Hospital of Tishreen University, Lattakia, Syria, during the period 1994-2003. Specimens were obtained from endoscopic and surgical biopsies. The immunohistochemical study was performed to analyze the immunophenotype of these lymphomas. RESULTS: Patients were aged 17-71 years. There was a slight predominance of females (male to female ratio, 13:15). Seventeen of the patients had tumors mainly located in the gastric antrum. Histologically, the most common lymphoma was of mucosa-associated lymphoid tissue (MALT) type (20 patients), also with diffuse large B-cell lymphoma (7 patients), and anaplastic large cell lymphoma (one patient). CONCLUSION: Our study demonstrates the different patterns of gastric lymphomas in Lattakia, Syria during a 10-year period in 28 Syrian patients, and reveals that the most primary gastric lymphomas are B-cell MALT lymphomas.     

原发性肺黏膜相关淋巴组织淋巴瘤侵犯心脏1例报道

原发性肺黏膜相关淋巴组织（mucosa-associated lymphoid tissue,MALT）淋巴瘤是一种罕见疾病。胸片或CT有可能将MALT淋巴瘤与其他肺部疾病相混淆,从而导致误诊或延误治疗,本例患者因为难以诊断而延误5年余。患者因胸痛就诊时发现右侧大量胸腔积液,当时给予抗结核治疗,但肺部病变仍缓慢进展,同时左肺也出现病变,纵膈内淋巴结融合,病变累及心脏,出现心包积液。在复旦大学附属中山医院经超声支气管镜行支气管、淋巴结及心房肿物穿刺病理检查,确诊为MALT淋巴瘤。     

胃黏膜相关淋巴组织淋巴瘤的循证诊疗:附病例报告

目的借助循证医学方法为一例胃黏膜相关淋巴组织(MALT)淋巴瘤患者确定治疗方案。方法在充分评估患者情况后,按照PICO原则提出临床问题并转化,计算机检索Cochrane Library、Medline、EMBase、维普资讯、万方数据库及中国知网,检索年限均为1990—2011年,收集相关高质量证据进行评价,并结合医生经验及患者愿望制定治疗方案。结果共纳入21篇文献,其中系统评价或Meta分析4篇,随机对照试验(RCT)9篇,病例报告8篇。结果显示,对于幽门螺杆菌(Hp)(+)的早期胃MALT淋巴瘤患者,首选Hp根除治疗。对于早期胃MALT淋巴瘤,化疗是有效的一线治疗。对于根除Hp无效的胃MALT淋巴瘤,放疗效果较为明显。化疗后手术治疗并不能提高早期高度恶性胃MALT淋巴瘤患者的预后,单纯化学治疗即可达到同样的效果。根据以上证据并结合患者意愿,对该例患者采用根除Hp三联疗法,治疗4周后,患者临床症状得到明显缓解,Hp、内镜检查结果均为阴性。结论 Hp(+)的早期胃MALT淋巴瘤患者,首选根除Hp治疗,可有效提高疗效和患者生活质量,但远期效果仍需进一步观察。     

幽门螺杆菌致病机制的研究进展

幽门螺杆菌(HP)是世界各地最常见的感染性病原之一,目前认为HP感染是慢性胃炎、消化性溃疡、胃MALT淋巴瘤、胃腺癌的主要病因,世界卫生组织将其归为一类致癌因子。但HP感染引起的人类胃肠疾病机制尚不清楚,可能与细菌毒力的高低尤其是HP基因多态性、细菌引起的炎症及免疫反应与宿主的免疫遗传等因素有关。     

胃黏膜相关淋巴组织淋巴瘤内镜特征

目的：探讨胃黏膜相关淋巴组织（MALT）淋巴瘤的内镜特征。方法：回顾性分析13例胃MALT淋巴瘤患者的内镜资料。结果：13例胃MALT淋巴瘤内镜下表现为：①病变累及胃体、窦分别占84.62%、61.54%，多部位病变84.62%，波及十二指肠、贲门分别为23.08%、30.78％。②弥漫性分布69.23%，局限性分布30.77％。③病变形态依次为溃疡型、浸润型、结节型分别占46.15%、30.77%、23.08%。④胃腔变形仅15.38%。⑤伴H.pylori感染率76.92%。⑥内镜确诊率61.54%。结论：内镜下胃MALT淋巴瘤呈病变范围广、病灶多发性、病变多态性、胃腔变形少四大特点，内镜为诊断胃MALT淋巴瘤的有效措施。     

胃黏膜相关淋巴组织淋巴瘤的临床治疗观察

目的:提高对胃黏膜相关淋巴组织(MALT)淋巴瘤的认识和诊疗水平,提高治愈率。方法:回顾性总结我院10年间115例胃黏膜相关淋巴组织淋巴瘤资料,手术标本重新病理诊断,明确分期诊断,并进行追踪随访。结果:98例经手术治疗,17例内科非手术治疗,患者胃MALT淋巴瘤的病变累计范围较广,胃窦、胃体、小弯侧多见形态多样,腹腔淋巴结易受累。病理属低度恶性,预后良好。结论:胃MALT淋巴瘤是一类新型淋巴瘤,与幽门螺旋菌感染有关,预后较好,生存期可延长。     

比较胃和眼附属器MALT淋巴瘤中T(11;18)的发生及相关的临床意义

目的:比较胃和眼附属器MALT淋巴瘤中的T(11;18),并探讨其相关的临床意义。方法:我们收集了眼附属器MALT1淋巴瘤1995~2007年福尔马林固定、石蜡包埋组织28例,并收集了同时期的胃MALT淋巴瘤福尔马林固定、石蜡包埋组织33例,其所有病例均为低度恶性胃MALT淋巴瘤,其中有22例患者接受过幽门螺旋杆菌(Helicobacter pylori,Hp)根除治疗。所有病例均应用间期FISH法检测T(11;18)在胃MALT淋巴瘤和眼附属器MALT淋巴瘤中的表达,并在胃MALT淋巴瘤中分析它们和Hp根除治疗反应性的关系。结果:T(11;18)在33例低度恶性胃MALT淋巴瘤中的检出率为6/33(18%),在28例眼附属器MALT淋巴瘤的检出率为0,两组间存在显著性差异(P<0.05);其中22例经Hp根除治疗的胃MALT淋巴病例中,16例完全缓解者2例(12.5%)检出该易位,6例对根除治疗无效者中有3例(50%)检出该易位,两组间存在显著差异(P<0.05)。结论:胃和眼附属器MALT淋巴瘤T(11;18)的发生率有差异,表明二者可能存在不同的细胞遗传学改变及发病机制;胃MALT淋巴瘤中T(11;18)的发生率与Hp根除治疗无反应相关;间期FISH法是检测石蜡包埋组织分子遗传学异常的有效而可靠的方法。     

Krukenberg tumor: report of two cases

Krukenberg tumor (KT) is a metastatic signet-ring adenocarcinoma of the ovary with variants of gastro-intestinal primary either detected synchronously or metachronously. Here two cases of Krukenberg tumor are reported with detected primary sites, one arising from the stomach and the second from the pancreas. The first case, a 35 year old multiparous woman with a past history of endoscopically proven gastric ulcer was diagnosed as a case of advanced gastric carcinoma with concomitant right adnexal mass. Endoscopic biopsy from the gastric growth revealed adenocarcimona (signet ring variety). As the primary gastric growth was not feasilble for surgical resection, palliative total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed. Histopathology of the ovary revealed metastatic adenocarcinoma with negative peritoneal cytology. After 4 cycles of chemotherapy, the patient died due to progression of primary cancer. The second patient, a 55 year old menopausal lady was diagnosed as a case of metastatic ovarian tumour with recurring ascitis upon chemotherapy. Comprehensive scanning revealed a thick walled lesion in the left side of the body and tail of the pancreas along with a left adnexal mass. Upon surgical exploration a vascular solid mass was identified in the pancreas which was not feasible for any sort of resection. Total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed. Poorly differentiated adenocarcinoma was found in the apparently shriveled up right ovary with positive peritoneal cytology. She succumbed to death due to reappearance of epigastric pain and haemorrhagic ascitis.     

以弥漫性病变为表现的肺黏膜相关淋巴组织淋巴瘤两例报告并文献复习

目的报告2例以弥漫性病变为影像学特点的肺黏膜相关淋巴组织（MALT）淋巴瘤病例,结合文献复习了解该特殊类型的影像学特点及其病理基础。方法回顾2例肺MALT淋巴瘤的临床表现、影像学特点及病理资料,结合有关文献进行回顾性分析。结果患者男性,59岁,临床主要表现为反复咳嗽5年,加重半年,病程长,抗感染、抗结核治疗无效;胸部CT示两肺弥漫性病变,胸膜增厚,两肺多发实变影、磨玻璃影,可见散在小结节影及牵拉性支气管扩张。胸腔镜肺活检病理示黏膜相关淋巴结外边缘区淋巴瘤（MALT淋巴瘤）,检测到免疫球蛋白IGH-FR1克隆性基因重排。患者女性,50岁,反复发热、咳嗽,伴有活动后气促;胸部CT示两肺多发大片实变影,内见支气管充气征。外周血嗜酸细胞显著升高。诊断为嗜酸细胞性肺炎,予激素正规治疗,症状改善,但肺部病变无明显吸收,后经皮肺穿刺活检病理诊断为MALT淋巴瘤。结论以弥漫性病变为表现的肺MALT淋巴瘤较为罕见,容易误诊。对于少见病及病灶散在者,支气管镜检查阳性率低,肺穿刺活检或胸腔镜活检能获得理想标本,有助于诊断。     

Endoscopic patterns of primary gastric MALT lymphoma

Primary low grade B-cell lymphoma of the mucosa associated lymphoid tissue (MALT), is an uncommon malignancy with a prolonged period of localized disease, and a possible transition to a high grade MALT lymphoma. The endoscopic diagnosis is often difficult, because of the various macroscopy patterns. The endoscopic aspects seen in 14 patients diagnosed and treated for primary gastric MALT lymphomas, were reviewed. Four main patterns were recognized: 1/Large ulcerations (n = 6, 42.9%), 2/Polypoid lesion (n = 2, 14.3%), 3/Gastritis with small ulcerations (n = 4, 28.5%), and 4/Atypical mucosal relief (AMR): erythema, nodularity, edematous or infiltrated folds (n = 2, 14.3%). In 10 cases (71%) AMR was associated with another endoscopic pattern. Histologically the tumors were of low grade (n = 11) and high grade (n = 3). On initial endoscopy a diagnosis of malignancy was done in 6 out of the 7 patients (85.7%) with large ulcers and the large polypoid mass; in contrast, an adequate endoscopic diagnosis was made in only 3 out of the 7 patients (42.8%) with ulcerative gastritis, AMR, and the small polypoid lesion. The endoscopic aspect of the latter group, representing 50% of all patients and 63.6% of the group with low grade MALT lymphomas, was indistinguishable from a benign lesion. Therefore it is important to be aware of this entity and perform biopsies in every patients with abnormal endoscopic findings.     

50例胃原发性恶性淋巴瘤临床特点分析

目的:探讨原发性胃淋巴瘤的临床特点, 提高原发性胃淋巴瘤的诊治水平。方法:回顾性分析中南大学湘雅医院肿瘤科2005 年9 月至2009 年9 月收治的50 例胃原发性恶性淋巴瘤。结果:原发性胃恶性淋巴瘤临床表现包括腹痛、上腹部不适、呕吐、黑便、食欲减退、发热、乏力、消瘦等, 其中最主要临床表现为腹痛。50 例胃原发性恶性淋巴瘤中, 1 例为外周T 细胞性淋巴瘤;49 例为B 细胞性淋巴瘤, 其中弥漫大B 细胞性淋巴瘤(di use large Bcell lymphoma, DLBCL) 34 例, 黏膜相关淋巴组织淋巴瘤(mucosa associated lymphoid tissue lymphoma, MALT) 13 例, DLBCL 合并MAIT 淋巴瘤2 例。50 例胃原发淋巴瘤患者中共12 例接受手术治疗, 所有患者均接受化学治疗。49 例DLBCL 患者中14 例接受利妥昔单抗联合化学治疗, 35 例单纯化学治疗, 利妥昔单抗联合化学治疗患者的2 年总生存率优于单纯化学治疗患者(85.7% vs 77.1%, P<0.05)。临床分期I~II 期的患者2 年总生存率优于临床分期III~IV 期的患者(90.9% vs 71.4%, P<0.05)。结论:原发性胃恶性淋巴瘤患者临床表现以消化道症状为主, 但无特异性, 腹痛是最常见的表现。临床以组织病理检查为金标准, 最常见病理类型为DLBCL。治疗选择以化学治疗为主的综合治疗, 患者预后与临床分期、是否联合美罗华化学治疗相关。治疗后50 例患者的2 年总生存率达80.0%。     

胃黏膜相关淋巴组织淋巴瘤的病理特征与疗效相关性分析

目的:探讨胃黏膜相关淋巴组成淋巴瘤(Mucosa-Associated Lymphoid Tissue,MALT)病理学特征与治疗方法之间的关系,以提高其疗效。方法:选择23例胃MALT淋巴瘤患者,统计其临床症状、内镜形态、病理特点,以及不同治疗方法所产生的疗效。结果:幽门螺杆菌(H.pylori)感染21例,感染率为91.3%;胃窦、胃体多灶性13例(56.5%),胃窦部9例(39.1%);病变局限于胃黏膜及黏膜下层20例(87.0%),侵犯肌层2例(8.7%),侵达浆膜1例(4.3%);21例H.pylori感染者均经质子泵抑制剂(PPI)加克拉霉素加阿莫西林规范治疗,根除H.pylori后2个月复查胃镜,17例(73.9%)病灶完全消失,随访2年内未复发;4例行COP方案化疗,其中3例病灶消退,随访至今未复发;1例出现恶化,1年后死亡。2例H.pylori阴性的巨大溃疡患者直接手术切除,术后均行CHOP方案化疗,随访5年未发现病灶复发。结论:胃MALT淋巴瘤与发病年龄、性别、肿瘤累及部位和体积大小等对生存率没有明显影响,而肿瘤侵犯深度和是否有远处转移与生率存在显著相关性,在不同发展阶段采取正确的治疗方法是提高治愈率的关键。     

Clinical and prognostic characteristice of pulmonary mucosa-associated lymphoid tissue lymphoma:a retrospective analysis of 23 cases in a chinese population

Background Pulmonary mucosa-associated lymphoid tissue (MALT) lymphoma is the most frequent type of non-Hodgkin's lymphoma (NHL) that primarily involves the lungs. It represents a rare entity accounting for less than 1%of all NHLs and the clinical features have yet to be clearly elucidated.Methods The clinicopathological features and radiological data of 23 patients with pulmonary MALT lymphoma confirmed by biopsy in Peking Union Medical College Hospital from January 2001 to December 2010 were retrospectively analyzed.Results At diagnosis,there were 15 women and 8 men. The median age was 55.1 years (range,37-73 years). One patient had a history of primary Sjoren's syndrome,another patient had a history of systemic lupus erythematosus (SLE)and secondary Sjoren's syndrome. One patient had a history of previous hematological malignancy (lymphomatoid papulosis in complete remission). In addition,one patient had simultaneous gastric and pulmonary involvement and one patient had simultaneous parotid gland and pulmonary involvement. The other 21 patients had disease localized within the lungs at the initial diagnosis. Among them,10 patients were asymptomatic while two had non-specific pulmonary symptoms. There were six patients with fever,four patients had low grade fever and two patients had moderate-high fever.The most common manifestations were cough (n=10),expectoration (n=8),exertional dyspnea (n=8),fatigue (n=7),body weight loss (n=6) and crackles (n=6). Blood tests showed low to moderate anemia in six cases,elevated erythrocyte semimentation rate (ESR) in 10 cases and only one patient had elevated lactate dehydrogenase (LDH). High resolution computed tomography (HRCT) of the chest revealed bilateral disease in 13 patients,air space consolidation with or without air bronchogram in 15 patients,lung nodules in 15 patients,patchy opacities in eight patients,lung mass in three patients and pleural effusion in five patients. Flexible fiberoptic bronchoscopy showed multiple nodules in five patients and almost normal morphology in 18 patients. Pathological diagnosis was obtained by bronchial biopsies in three cases,by CT-guided percutaneous lung biopsies in 11 cases and by surgical biopsies in nine cases. Of the 23 patients,one remained untreated,while 22 received various combinations of treatment (surgery alone in three patients,surgery plus chemotherapy in six patients,and chemotherapy alone in 13 patients). Twenty-one patients remained alive during the median follow-up of 23 (0.25-84) months,while one patient died from unknown causes,one patient died from lung infection.Conclusions Pulmonary MALT lymphoma tends to occur in old-aged females and to be limited to the lungs on the initial diagnosis and LDH's level was normal in most patients. Lung nodules,patchy opacities and air space consolidation     

Tracheal stenting for primary tracheal mucosa-associated lymphoid tissue lymphoma

Primary tracheal mucosa-associated lymphoid tissue (MALT) lymphoma is extremely rare. We report a 49-year-old female patient with the complaint of dyspnea. Fiberoptic bronchoscopy showed polypoid, variable-sized and irregular nodules causing narrowing of the tracheal lumen from the proximal trachea to the left main bronchus. Because of severe stenosis in the airway and the severity of symptoms, this case was unresectable. The patient was then treated successfully with placement of an endobronchial stent through bronchofibroscopy. After the placement of the stent, bronchoscopic biopsy was performed. Pathological analysis confirms a diagnosis of MALT-associated malignant lymphoma. We performed systemic chemotherapy on the patient. The temporary stent was removed after the reduction of the stenosis. This is the first case in which tracheal MALT lymphoma was treated successfully following tracheal stent insertion guided by bronchofibroscopy. Temporary tracheal stenting can be a favorable choice for a patient with tracheal stenosis caused by primary tracheal MALT lymphoma.     

37例黏膜相关淋巴组织型淋巴瘤的病理、临床资料分析

目的：为开展黏膜相关淋巴组织型（MALT）淋巴瘤的标准化诊断和规范化治疗提供病理及临床依据。方法：对我院2000年1月至2002年6月诊断的37例MALT型淋巴瘤的病理、临床分期、恶性程度、预后因素及治疗进行回顾性分析。结果：442例非霍奇金淋巴瘤（NHL）中MALT型39例占8.82%（可追踪病例37例），发病中位年龄52岁，50岁以上患者占63．6％。MALT型NHL的发病部位以胃肠最多见，共28例，占71．8％；其次为甲状腺、腮腺、眼眶、肺。MALT型NHL中低度恶性占70．3％，低度恶性伴转化（中度恶性）占27％。临床分期I期占53．6％，Ⅱ期28.6%,Ⅲ期14．3％，Ⅳ期3．6％。37例可追踪MALT型NHL的病理标本中35例表达CD20抗原，2例不确定，其中4例疑难病例通过PCR检测IgH克隆性重排协助诊断。13例胃MALT型淋巴瘤行幽门螺杆菌（HP）检测，阳性率为46．15％。胃MALT型淋巴瘤患者均接受抗HP三联治疗，仅1例接受单纯抗生素治疗。28例胃肠MALT型淋巴瘤患者除5例外，均曾接受手术治疗；多数患者接受系统化疗，部分加局部放疗，尚无接受单纯胃放射治疗者。结论：MALT型淋巴瘤多发生于老年患者，以低度恶性为主，肿瘤发展进程缓慢；不同的发病部位、分类、分期及分子遗传学改变均为重要的预后风险因素，可用于协助选择合适的治疗方案。     

胃肠粘膜相关淋巴组织淋巴瘤20例临床分析

目的总结胃肠粘膜相关淋巴组织(MALT)淋巴瘤的诊治体会及经验。方法对近5年收治的20例胃肠MALT淋巴瘤患者进行回顾性分析。结果①胃肠MALT淋巴瘤多发生于50岁以上患者,男性多于女性;②胃肠MALT淋巴瘤内镜下表现多样化、无特异性,镜检时应采取多点、深挖活检以提高早期检出率;③治疗应首选手术治疗,失去手术机会的患者,若坚持化疗,可改善其生活质量,延长生存期;④传统的CHOP方案效果可靠,花费少;⑤部分MALT淋巴瘤病理切片中可见少量印戒样细胞,需与高度恶性的印戒细胞癌鉴别。结论胃肠MALT淋巴瘤临床表现不典型,确诊应根据内镜、病理和免疫组化结果综合判断。     

MALT淋巴瘤临床病理分析

目的:观察黏膜相关淋巴组织结外边缘区B细胞淋巴瘤(MALT淋巴瘤)的临床和病理特点。方法:回顾性分析海南医学院附属医院病理科2000年1月~2010年8月29例MALT淋巴瘤的临床病理资料,通过HE染色和免疫组化染色进行病理组织学观察。结果:29例MALT淋巴瘤中,发生于胃肠道共25例,占86.21%,临床主要表现为胃肠道疾病非特异性症状,其中13例胃MALT淋巴瘤中,HP感染10例,感染率为76.92%;发生于眼眶3例,甲状腺1例。镜下肿瘤组织主要由小淋巴细胞组成,部分病例伴有少量大细胞和淋巴上皮病变。瘤细胞表达B淋巴细胞免疫标记CD20和CD79a,CD5和CD10无表达。结论:胃肠道是MALT淋巴瘤的好发部位,不同部位的MALT淋巴瘤具有共同的细胞形态和免疫表型特征。     

STAT3磷酸化对胃MALT淋巴瘤细胞凋亡的调控作用

目的　探讨STAT3磷酸化对胃MALT淋巴瘤细胞凋亡的调控作用。方法　采用SP免疫组织化学方法检测了 45例胃MALT淋巴瘤细胞及 13例滤泡型淋巴结反应性增生病 (RH)的p -STAT3、促凋亡基因 /蛋白fas和抗凋亡基因 /蛋白bcl-2的表达。结果　p -STAT3、fas及bcl-2蛋白在胃MALT淋巴瘤细胞中均呈过度表达 (阳性率分别为 64 .4%、60 .0 %和 66.7% ) ;低度恶性组的fas蛋白阳性信号强度明显低于高度恶性组 (P <0 .0 5 ) ,而bcl-2蛋白则明显高于高度恶性组 (P <0 .0 5 ) ,在低度与高度恶性组间的p -STAT3阳性表达强度无明显差异 (P >0 .0 5 ) ;p -STAT3与fas蛋白在胃MALT淋巴瘤细胞中的阳性表达呈明显的负相关 (r=-0 .6791,P <0 .0 5 ) ,而与bcl -2蛋白的阳性表达则呈明显的正相关 (r=0 .72 3 1,P <0 .0 5 )。结论　STAT3活化可能通过抑制细胞凋亡导致胃MALT淋巴瘤细胞的恶性转化及高增殖性 ,并在其演进中起重要作用