152例接受手术治疗的原发性胃淋巴瘤的临床病理研究及109例高级别肿瘤的生存分析
A clinicopathological study of 152 surgically treated primary gastric lymphomas with survival analysis of 109 high grade tumours.
作者信息
Ranaldi R, Goteri G, Baccarini M G, Mannello B, Bearzi I
机构信息
Department of Pathology, University of Ancona School of Medicine, 60020 Torrette di Ancona, Italy.
出版信息
J Clin Pathol. 2002 May;55(5):346-51. doi: 10.1136/jcp.55.5.346.
AIMS
To describe the clinicopathological features of a large number of surgically treated and followed up primary gastric lymphomas and thereby gain a better understanding of their biology, with particular reference to the prognostic factors of high grade tumours.
METHODS
A retrospective study of 152 patients.
RESULTS
High grade gastric lymphomas, both pure and with a residual low grade component, differed from low grade mucosa associated lymphoid tissue (MALT)-type lymphomas in that they were more frequently large, ulcerated, at an advanced stage, and highly proliferating. In addition, patients were older and had a worse outcome. The prognosis of high grade lymphomas was influenced by patient age, tumour stage, depth of infiltration in the gastric wall, and the invasion of adjacent organs. Adjuvant postsurgical treatment prolonged survival only in patients with advanced stage and deep neoplastic infiltration.
CONCLUSIONS
There is a sharp distinction between low grade MALT-type lymphomas and tumours with a high grade component, justifying their different treatment approach. The postsurgical management of high grade lymphomas should be based on the accurate evaluation of the neoplastic extension.
目的
描述大量接受手术治疗并随访的原发性胃淋巴瘤的临床病理特征，从而更好地了解其生物学特性，尤其关注高级别肿瘤的预后因素。
方法
对152例患者进行回顾性研究。
结果
高级别胃淋巴瘤，包括单纯型和伴有残留低级别成分的类型，与低级别黏膜相关淋巴组织（MALT）型淋巴瘤不同，前者更常体积较大、有溃疡、处于晚期且增殖活跃。此外，患者年龄较大且预后较差。高级别淋巴瘤的预后受患者年龄、肿瘤分期、胃壁浸润深度及邻近器官侵犯情况影响。辅助性手术后治疗仅能延长晚期且肿瘤浸润较深患者的生存期。
结论
低级别MALT型淋巴瘤与含有高级别成分的肿瘤之间存在明显差异，这证明了它们不同的治疗方法是合理的。高级别淋巴瘤的术后管理应基于对肿瘤扩展情况的准确评估。
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