Nakamura Shotaro, Matsumoto Takayuki
Division of Gastroenterology, Department of Internal Medicine, School of Medicine, Iwate Medical University, Uchimaru 19-1, Morioka 020-8505, Japan.
Division of Gastroenterology, Department of Internal Medicine, School of Medicine, Iwate Medical University, Uchimaru 19-1, Morioka 020-8505, Japan.
Gastroenterol Clin North Am. 2015 Sep;44(3):649-60. doi: 10.1016/j.gtc.2015.05.012. Epub 2015 Jun 23.
Recent trends and current knowledge on the diagnosis and treatment strategy for gastric mucosa-associated lymphoid tissue (MALT) lymphoma are reviewed. Helicobacter pylori infection plays the causative role in the pathogenesis, and H pylori eradication is the first-line treatment of this disease, which leads to complete remission in 60% to 90% of cases. A Japanese multicenter study confirmed that the long-term outcome of gastric MALT lymphoma after H pylori eradication is excellent. Treatment strategies for patients not responding to H pylori eradication including "watch and wait" strategy, radiotherapy, chemotherapy, rituximab immunotherapy, and combination of these should be tailored in consideration of the disease extent in each patient.
本文综述了胃黏膜相关淋巴组织(MALT)淋巴瘤诊断和治疗策略的最新趋势及当前认知。幽门螺杆菌感染在发病机制中起致病作用,根除幽门螺杆菌是该病的一线治疗方法,60%至90%的病例可实现完全缓解。一项日本多中心研究证实,根除幽门螺杆菌后胃MALT淋巴瘤的长期预后良好。对于根除幽门螺杆菌无反应的患者,治疗策略包括“观察等待”策略、放疗、化疗、利妥昔单抗免疫疗法,以及应根据每位患者的疾病范围量身定制的这些方法的联合应用。