Fischbach Wolfgang
Gastroenterologie Aschaffenburg, Aschaffenburg, Germany.
Z Gastroenterol. 2022 Apr;60(4):602-612. doi: 10.1055/a-1676-5104. Epub 2021 Nov 24.
Gastric MALT- (mucosa-associated-lymphoid-tissue) lymphoma represents the most frequent gastrointestinal lymphoma. For decades, surgery and later on radiation and chemotherapy were regarded as established therapy. Some 30 years ago, the pathogenetic role of Helicobacter pylori infection for the development of gastric MALT-lymphoma became evident. During the following years, the pathogenetic insights were consequently implemented into clinical medicine. This lead to a radical change of the therapeutic approach to these lymphoma. Nowadays, Helicobacter pylori eradication is the internationally established therapy of first choice. It is followed by lymphoma regression in most cases. The long-term prognosis of patients after exclusive eradication therapy is excellent, even if endoscopic and/or histological residuals persist and a watch-and-wait strategy is favored.The pathogenetic insights und their clinical application implicated a consequent deescalation of therapy of gastric MALT-lymphoma. This review summarizes the single steps of this development and gives a recommendation for the actual management of patients with gastric MALT lymphoma.
胃黏膜相关淋巴组织（MALT）淋巴瘤是最常见的胃肠道淋巴瘤。几十年来，手术以及后来的放疗和化疗一直被视为既定的治疗方法。大约30年前，幽门螺杆菌感染在胃MALT淋巴瘤发生发展中的致病作用变得明显。在随后的几年里，这些致病机制的见解相应地被应用于临床医学。这导致了对这些淋巴瘤治疗方法的彻底改变。如今，根除幽门螺杆菌是国际上公认的首选治疗方法。在大多数情况下，随后淋巴瘤会消退。即使内镜和/或组织学上仍有残留且倾向于采取观察等待策略，单纯根除治疗后患者的长期预后也很好。致病机制的见解及其临床应用意味着胃MALT淋巴瘤治疗的相应降级。本综述总结了这一发展的各个阶段，并对胃MALT淋巴瘤患者的实际管理提出了建议。
