Zullo Angelo, Hassan Cesare, Ridola Lorenzo, Repici Alessandro, Manta Raffaele, Andriani Alessandro
Gastroenterology and Digestive Endoscopy, 'Nuovo Regina Margherita' Hospital, Rome (Angelo Zullo, Cesare Hassan, Lorenzo Ridola).
Department of Gastroenterology, IRCCS Istituto Clinico Humanitas, Milan (Alessandro Repici).
Ann Gastroenterol. 2014;27(1):27-33.
The stomach is the most frequent site of extranodal lymphoma. Gastric lymphoma originating from mucosa-associated lymphoid tissue (MALT) is typically a low-grade, B-cell neoplasia strongly associated with () infection. Only certain strains in some predisposed patients determine lymphoma development in the stomach, according to a strain-host-organ specific process. The clinical presentation is poorly specific, symptoms ranging from vague dyspepsia to alarm symptoms. Similarly, different endoscopy patterns have been described for gastric lymphoma. eradication is advised as first-line therapy in early stage disease, and complete lymphoma remission is achieved in 75% of cases. Neoplasia stage, depth of infiltration in the gastric wall, presence of the translocation, localization in the stomach, and patient ethnicity have been identified as predictors of remission. Recent data suggests that eradication therapy may be successful for gastric lymphoma treatment also in a small subgroup (15%) of -negative patients. The overall 5-year survival and disease-free survival rates are as high as 90% and 75%, respectively. Management of patients who failed to achieve lymphoma remission following eradication include radiotherapy, chemotherapy and, in selected cases, surgery.
胃是结外淋巴瘤最常见的发病部位。起源于黏膜相关淋巴组织（MALT）的胃淋巴瘤通常是一种低度恶性的B细胞肿瘤，与（）感染密切相关。根据菌株-宿主-器官特异性过程，只有某些菌株会在一些易感患者中导致胃部淋巴瘤的发生。其临床表现特异性较差，症状从模糊的消化不良到警示症状不等。同样，胃淋巴瘤也有不同的内镜表现。对于早期疾病，建议将（）根除作为一线治疗，75%的病例可实现淋巴瘤完全缓解。肿瘤分期、胃壁浸润深度、（）易位的存在、在胃内的定位以及患者种族已被确定为缓解的预测因素。最近的数据表明，在一小部分（15%）（）阴性患者中，（）根除治疗对于胃淋巴瘤治疗也可能成功。总体5年生存率和无病生存率分别高达90%和75%。根除治疗后未能实现淋巴瘤缓解的患者的管理包括放疗、化疗，以及在特定情况下进行手术。
