Department of R/D for Surgical Support System, Center for Advanced Medical Innovation, Kyushu University, Fukuoka, Japan.
Digestion. 2013;87(3):182-8. doi: 10.1159/000350051. Epub 2013 Apr 27.
The recent trends in the diagnosis and management of gastrointestinal lymphoma are reviewed. Primary gastrointestinal lymphoma accounts for 30-40% of all extranodal lymphomas, while it comprises only 1-8% of all gastrointestinal malignancies. The most common histological type is mucosa-associated lymphoid tissue lymphoma, followed by diffuse large B-cell lymphoma. Recently, the incidence of intestinal follicular lymphoma has been increasing. Balloon-assisted endoscopy and capsule endoscopy are essential tools for the assessment of small bowel lymphomas. Treatment modalities for gastrointestinal lymphomas include 'watch and wait' strategy, antibiotics (e.g., Helicobacter pylori eradication), radiotherapy, chemotherapy, surgical resection, immunotherapy (e.g. rituximab), and combinations of these. Optimal therapeutic strategies should be determined based on the involved site, histological type, and clinical stage. It should be noted that accurate pretreatment diagnosis of the disease is most important.
本文回顾了胃肠道淋巴瘤的诊断和治疗新进展。原发性胃肠道淋巴瘤占所有结外淋巴瘤的 30-40%,而仅占所有胃肠道恶性肿瘤的 1-8%。最常见的组织学类型是黏膜相关淋巴组织淋巴瘤,其次是弥漫性大 B 细胞淋巴瘤。最近,小肠滤泡性淋巴瘤的发病率一直在增加。气囊辅助内镜和胶囊内镜是评估小肠淋巴瘤的重要工具。胃肠道淋巴瘤的治疗方法包括“观察和等待”策略、抗生素(如幽门螺杆菌根除)、放疗、化疗、手术切除、免疫疗法(如利妥昔单抗)以及这些方法的联合应用。应根据受累部位、组织学类型和临床分期来确定最佳治疗策略。需要注意的是,准确的疾病术前诊断最为重要。