胃黏膜相关淋巴组织淋巴瘤临床研究及随访

目的探讨胃黏膜相关淋巴组织淋巴瘤的临床特征及治疗策略。方法采用回顾性方法对32例经组织学确诊的胃黏膜相关淋巴组织淋巴瘤进行随访。结果32例患者中多数起病隐匿，上腹痛为主要症状，也有以消化道出血入院者。内镜下病变主要分布在胃窦部，以隆起型和溃疡型表现为主。首次胃镜检查约25％获正确诊断。本组病例幽门螺杆菌感染率约为88％。20例（62．5％）接受了手术治疗，15例（46．88％）行幽门螺杆菌根除治疗，其中，3例早期阶段患者获得组织学完全缓解。结论胃黏膜相关淋巴组织淋巴瘤的临床表现、内镜下特征和病理特点的认识有待进一步提高。对早期阶段患者幽门螺杆菌治疗当属首选。

Clinical research and follow-up study of gastric mucosa-associated lymphoid tissue lymphoma

Objective To investigate the clinical characteristics and the therapy strategy of the gastric mucosa-asso- ciated lymphoid tissue lymphoma. Methods A cohort of 32 gastric mucosa-associated lymphoid tissue lymphoma patients proven by biopsy were followed up by retrospective study. Results For thirty-two patients, the symptoms started indistinctly, and chronic gastralgia was the chief. Some of them were admitted for gastrointestinal hemorrhage. Under endoscopy, gastric antrum was the most common site of the gastric mucosa-associated lymphoid tissue lymphoma. The main pathological changes were upheaval type and ulcer type. The lymphoma was made definite so difficult that 25% ones could be diagnosed by endoscopy correctly at the first time. Besides, Helicobacter pylori infection was found in 22 cases（88% ）. Among 32 cases, 20 （62.5%） accepted surgery, 15 （46.88%） received H. pylori eradication therapy, of which 3 cases achieved histological complete remission. Conclusion We should attach importance to the clinical, endoscopic and pathologic features of gastric mucosa-associated lymphoid tissue lymphoma. For patients with gastric mu- cosa-associated lymphoid tissue lymphoma, H. pylori eradication should be well recommended in its early stage.