Hu Chuangying, Yi Cuiqiong, Dai Xiaobo
Department of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China.
J Gastroenterol Hepatol. 2006 Apr;21(4):722-6. doi: 10.1111/j.1440-1746.2006.04249.x.
The purpose of the present paper was to investigate the clinical, endoscopic and histological features of 31 patients with gastric mucosa-associated lymphoid tissue (MALT) lymphoma to enable correct, early stage diagnosis.
A retrospective study was undertaken of 31 patients with gastric MALT lymphoma. The cases were examined immunohistologically with anti-CD(20CY) and CD(45RO) antibodies for further diagnosis. Helicobacter pylori infection was also detected with modified Giemsa staining.
Patients with MALT lymphoma were aged between 22 and 73 years (mean, 45.0 years), and the male:female ratio was 11:20. The patients presented with non-specific symptoms, but chronic epigastric pain was the common symptom in a large proportion of the cases. The gastric smaller curvature was involved in 83.9% of cases (26/31) and in 13/31 cases (41.9%) it was confined the antrum. Under endoscopy, large and deep ulcers were similar to cancers in the majority of patients. Only 29.0% of patients were diagnosed by endoscopy on first examination. CD(20CY) were expressed in all cases and CD(45RO) expressed in only one case among 10 cases of indefinite diagnosis. Helicobacter pylori infection was found in 87.1% of patients.
These findings suggest that primary gastric MALT lymphoma has unique clinical, endoscopic and histological features. The diagnosis for primary gastric MALT lymphoma was delayed not only due to the non-specific symptoms but also due to lack of attention to its features. Endoscopy and submucosal multiple biopsy were the principal diagnostic tools in patients with gastric MALT lymphoma. CD(20CY) and CD(45RO) immunological staining are recommended, especially for patients with indefinite diagnosis of gastric MALT lymphoma.
本文旨在研究31例胃黏膜相关淋巴组织（MALT）淋巴瘤患者的临床、内镜及组织学特征，以实现正确的早期诊断。
对31例胃MALT淋巴瘤患者进行回顾性研究。采用抗CD(20CY)和CD(45RO)抗体进行免疫组织化学检查以进一步诊断。同时采用改良吉姆萨染色检测幽门螺杆菌感染情况。
MALT淋巴瘤患者年龄在22至73岁之间（平均45.0岁），男女比例为11:20。患者表现为非特异性症状，但大部分病例中慢性上腹部疼痛是常见症状。83.9%的病例（26/31）胃小弯受累，41.9%的病例（13/31）局限于胃窦部。在内镜检查中，大多数患者的大而深的溃疡与癌症相似。初次检查时仅29.0%的患者通过内镜检查确诊。在10例诊断不明确的病例中，所有病例均表达CD(20CY)，仅1例表达CD(45RO)。87.1%的患者检测到幽门螺杆菌感染。
这些发现表明原发性胃MALT淋巴瘤具有独特的临床、内镜及组织学特征。原发性胃MALT淋巴瘤的诊断延迟不仅是由于非特异性症状，还由于对其特征缺乏关注。内镜检查及黏膜下多处活检是胃MALT淋巴瘤患者的主要诊断工具。建议进行CD(20CY)和CD(45RO)免疫染色，特别是对于诊断不明确的胃MALT淋巴瘤患者。
