Min Byung-Hoon, Park Jun Young, Kim Eun Ran, Min Yang Won, Lee Jun Haeng, Rhee Poong-Lyul, Rhee Jong Chul, Kim Jae J
Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Gut Liver. 2014 Nov;8(6):637-42. doi: 10.5009/gnl13284. Epub 2014 Nov 15.
BACKGROUND/AIMS: The aim of this study was to investigate the frequency of disseminated gastric mucosa-associated lymphoid tissue (MALT) lymphoma and the role of bone marrow study in the initial staging work-up.
A total of 194 patients with gastric MALT lymphoma was enrolled. The incidence of disseminated disease was evaluated in the initial staging work-up. The demographic data and tumor characteristics were compared according to Helicobacter pylori infection status.
Localized disease of Lugano stage I accounted for 97.4% of the enrolled cases. Abdominal computed tomography revealed abdominal lymph node metastasis in five patients (2.6%). Bone marrow (BM) involvement was found in only one patient without H. pylori infection (0.5%). No patient showed positive findings on chest computed tomography or positron emission tomography. H. pylori-negative cases showed a significantly higher frequency of advanced-stage disease than H. pylori-positive cases (10.0% vs 0.6%). In patients achieving complete remission, no extragastric recurrence occurred during follow-up.
The incidence of disseminated disease, including BM involvement, was very low in Korean gastric MALT lymphoma patients. It might be beneficial to perform BM aspiration and biopsy as a part of staging work-up only in patients with risk factors for advanced disease such as H. pylori negativity.
背景/目的：本研究旨在调查弥漫性胃黏膜相关淋巴组织（MALT）淋巴瘤的发生率以及骨髓检查在初始分期评估中的作用。
共纳入194例胃MALT淋巴瘤患者。在初始分期评估中评估弥漫性疾病的发生率。根据幽门螺杆菌感染状况比较人口统计学数据和肿瘤特征。
卢加诺I期局限性疾病占纳入病例的97.4%。腹部计算机断层扫描显示5例患者（2.6%）有腹部淋巴结转移。仅1例无幽门螺杆菌感染的患者发现骨髓受累（0.5%）。胸部计算机断层扫描或正电子发射断层扫描均未发现患者有阳性结果。幽门螺杆菌阴性病例的晚期疾病发生率显著高于幽门螺杆菌阳性病例（10.0%对0.6%）。在达到完全缓解的患者中，随访期间未发生胃外复发。
韩国胃MALT淋巴瘤患者中包括骨髓受累在内的弥漫性疾病发生率非常低。仅对有晚期疾病危险因素（如幽门螺杆菌阴性）的患者进行骨髓穿刺和活检作为分期评估的一部分可能是有益的。
