Flieger D, Fischbach W
Medizinische Klinik, GP-Klinikum Rüsselsheim.
Praxis (Bern 1994). 2006 Aug 2;95(31-32):1163-8. doi: 10.1024/0369-8394.95.31.1163.
Gastric lymphoma is most frequently an extranodal marginal zone-B-cell-lymphoma of mucosa-associated lymphoid tissue (MALT). The diagnosis is established by biopsy of the tumor. Computed-tomography, endosonography and recently capsule-endoscopy are used for staging. It is a relative new finding that MALT-lymphomas of the stomach are induced by Helicobacter pylori. A side-effect-poor breakthrough has been achieved by eradication of this bacterium with antibiotics. Refractory cases are amenable to radiotherapy, chemotherapy or surgical resection. The rarer aggressive lymphomas of the stomach are treated primarily by chemotherapy and radiotherapy. For both entities a further improvement may be achieved in ongoing prospective clinical trials by addition of the monoclonal antibody rituximab, which targets CD20 on lymphoma cells.
胃淋巴瘤最常见的是黏膜相关淋巴组织(MALT)的结外边缘区B细胞淋巴瘤。通过肿瘤活检确诊。计算机断层扫描、内镜超声检查以及最近的胶囊内镜检查用于分期。胃MALT淋巴瘤由幽门螺杆菌诱发是一项相对较新的发现。通过用抗生素根除这种细菌已取得了副作用较小的突破。难治性病例适合放疗、化疗或手术切除。胃中较罕见的侵袭性淋巴瘤主要通过化疗和放疗进行治疗。对于这两种类型的淋巴瘤,在正在进行的前瞻性临床试验中,通过添加靶向淋巴瘤细胞上CD20的单克隆抗体利妥昔单抗可能会进一步改善治疗效果。