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目的探讨胃粘膜相关淋巴组织 (MALT)淋巴瘤临床和内镜表现特征及其内在联系。 方法总结 1985年~ 1999年我院经手术及病理证实的 32例胃 MALT淋巴瘤患者临床和内镜资料。结果 32例患者平均就诊时间为 15.6月 ,平均年龄 51.3岁, 30~ 39岁及 60~ 69岁为发病高峰,男女比例 1.9:1。患者症状不具有特异性 ,腹痛是其最常见表现。病变累及胃窦 12例,胃体 8例,多部位者 12例。内镜下表现为弥漫型 10例,溃疡型 16例,结节型 6例。各型症状、体征无显著差异。弥漫型病灶在累及浆膜层前已发生淋巴结转移。内镜确诊率 62.5%。 32例均为 B细胞淋巴瘤,其中 27例伴幽门螺杆菌 (Hp)感染( 84.4%)。结论胃 MALT淋巴瘤发病年龄呈双峰现象,男性居多,起病隐袭,症状、体征不具有特异性。内镜下病变范围广、病灶多发是其特点,各型临床表现无显著差异,但弥漫型容易发生周围淋巴结转移。内镜下多块取检、深取检以及及时做免疫组化检查可提高内镜诊断准确率。 Hp感染可能与胃 MALT淋巴瘤的发生有关。
Objective To investigate the clinical and endoscopic features and intrinsic connections of gastric mucosa-associated lymphoid tissue (MALT) lymphoma. Methods Clinical and endoscopic data of 32 patients with gastric MALT lymphoma confirmed by surgery and pathology from 1985 to 1999 were collected. Results The average visit time of 32 patients was 15.6 months, with an average age of 51.3 years, 30 to 39 years and 60 to 69 years of age as the peak incidence. The ratio of men and women was 1.9:1. The patient’s symptoms are not specific and abdominal pain is the most common manifestation. Lesions involved 12 cases of gastric antrum, 8 cases of gastric body, and 12 cases of multiple sites. The endoscopic manifestations were diffuse in 10 cases, ulcer in 16 cases, and nodular in 6 cases. There were no significant differences among various types of symptoms and signs. Diffuse lesions have undergone lymph node metastasis before involving the serosal layer. The endoscopic diagnosis rate was 62.5%. Thirty-two cases were all B-cell lymphomas, 27 of whom were infected with Helicobacter pylori (Hp) (84.4%). Conclusions The onset age of gastric MALT lymphoma is a bimodal phenomenon. Most of the males have an insidious onset, and the symptoms and signs are not specific. Endoscopic lesions with a wide range of lesions, multiple lesions is its characteristics, no significant difference in clinical manifestations of various types, but diffuse type is easy to occur around the lymph node metastasis. Multiple endoscopic examinations, deep examinations, and timely immunohistochemical examinations can improve the diagnostic accuracy of endoscopy. Hp infection may be related to the occurrence of gastric MALT lymphoma.