Division of Endoscopy, Hokkaido University Hospital, Sapporo, Japan.
J Gastroenterol Hepatol. 2011 Jul;26(7):1133-8. doi: 10.1111/j.1440-1746.2011.06729.x.
We have reported the characteristics of magnified endoscopic images of gastric mucosa-associated lymphoid tissue (MALT) lymphoma before and after treatment. In this study, we investigated the diagnostic efficacy of magnified endoscopic images for target biopsy and evaluation of clinical remission.
Twenty-one patients diagnosed with localized gastric MALT lymphoma were enrolled. Magnified endoscopy was performed prior to treatment and at a mean period of 1.8 months (1-6 months) after therapy (Helicobacter pylori eradication in 19 patients and radiation therapy in two patients). Microstructural pattern and abnormal vessels in the lesions were assessed, and corpus mucosa without lymphoma was divided into H. pylori-negative mucosa and H. pylori-positive mucosa. Biopsy was the gold standard in this study.
Nonstructural areas with abnormal vessels were observed in all patients before treatment. Fifteen patients achieved pathological complete remission. Disappearance of nonstructural areas and abnormal vessels after therapy was associated with pathological remission. Sensitivities of these findings for diagnosis were 76.9% and 85.7%, respectively, and the specificities were 87.5% and 85.7%, respectively. H. pylori eradication therapy was invalid in three patients with H. pylori-negative mucosa in magnified images.
Magnifying endoscopy may be useful for target biopsy of superficial gastric MALT lymphoma in clinical management.
我们曾报道过胃黏膜相关淋巴组织（MALT）淋巴瘤治疗前后放大内镜图像的特征。本研究旨在探讨放大内镜图像对目标活检和临床缓解评估的诊断效能。
共纳入 21 例经组织学确诊的局限性胃 MALT 淋巴瘤患者。在治疗前（19 例接受了幽门螺杆菌根除治疗，2 例接受了放射治疗）和治疗后平均 1.8 个月（1-6 个月）时进行放大内镜检查。评估病变的微观结构模式和异常血管，并将无淋巴瘤胃体黏膜分为幽门螺杆菌阴性黏膜和幽门螺杆菌阳性黏膜。本研究以活检为金标准。
所有患者在治疗前均观察到非结构区域存在异常血管。15 例患者达到病理完全缓解。治疗后非结构区域和异常血管的消失与病理缓解相关。这些发现对诊断的敏感度分别为 76.9%和 85.7%，特异性分别为 87.5%和 85.7%。在放大图像中幽门螺杆菌阴性的 3 例患者中，幽门螺杆菌根除治疗无效。
放大内镜可用于指导胃 MALT 淋巴瘤的目标活检，以辅助临床管理。
