Park Jeong Bae, Koo Ja Seol
Jeong Bae Park, Department of Internal Medicine, College of Medicine, Dongguk University, Gyeongju 780-350, South Korea.
World J Gastroenterol. 2014 Mar 21;20(11):2751-9. doi: 10.3748/wjg.v20.i11.2751.
Gastrointestinal lymphoma is the most common type of extranodal lymphoma, and most commonly affects the stomach. Marginal zone B-cell lymphoma of the mucosa-associated lymphoid tissue (MALT) and diffuse large B-cell lymphoma are the most common histologic types of gastric lymphoma. Despite its increasing incidence, diagnosis of gastric lymphoma is difficult at an earlier stage due to its nonspecific symptoms and endoscopic findings, and, thus, a high index of suspicion, and multiple, deep, repeated biopsies at abnormally and normally appearing sites in the stomach are needed. In addition, testing for Helicobacter pylori (H. pylori) infection and endoscopic ultrasonography to determine the depth of tumor invasion and involvement of regional lymph nodes is essential for predicting response to H. pylori eradication and for assessment of disease progression. In addition, H. pylori infection and MALT lymphoma development are associated, and complete regression of low-grade MALT lymphomas after H. pylori eradication has been demonstrated. Radiotherapy and/or chemotherapy can be used in cases that show poor response to H. pylori eradication, negativity for H. pylori infection, or high-grade lymphoma.
胃肠道淋巴瘤是最常见的结外淋巴瘤类型,最常累及胃部。黏膜相关淋巴组织边缘区B细胞淋巴瘤(MALT)和弥漫性大B细胞淋巴瘤是胃淋巴瘤最常见的组织学类型。尽管其发病率不断上升,但由于其非特异性症状和内镜检查结果,胃淋巴瘤在早期很难诊断,因此,需要高度怀疑,并在胃内异常和正常出现的部位进行多次、深部、重复活检。此外,检测幽门螺杆菌(H. pylori)感染以及进行内镜超声检查以确定肿瘤浸润深度和区域淋巴结受累情况对于预测幽门螺杆菌根除反应和评估疾病进展至关重要。此外,幽门螺杆菌感染与MALT淋巴瘤的发生有关,并且已证明根除幽门螺杆菌后低度MALT淋巴瘤可完全消退。对于根除幽门螺杆菌反应不佳、幽门螺杆菌感染阴性或高级别淋巴瘤的病例,可采用放疗和/或化疗。