Fischbach Wolfgang, Neubauer Andreas, Reinartz Gabriele
Medizinische Klinik II und Klinik für Palliativmedizin, Klinikum Aschaffenburg-Alzenau, Akademisches Lehrkrankenhaus der Universität Würzburg, Aschaffenburg, Deutschland.
Gastroenterologische Gemeinschaftspraxis Aschaffenburg, Elisenstraße 32, 63739, Aschaffenburg, Deutschland.
Inn Med (Heidelb). 2024 Jul;65(7):690-700. doi: 10.1007/s00108-024-01715-1. Epub 2024 Jun 4.
Mucosa-associated lymphomas of the gastrointestinal tract are a heterogeneous group differing in pathogenesis, localization and therapeutic options. For all of them, differentiated treatment requires an exact determination of lymphoma stage. For gastric MALT lymphoma, the pathogenetic role of Helicobacter pylori infection has become evident in the last 30 years. These insights were consequently implemented into clinical practice. Nowadays, Helicobacter pylori eradication is the treatment of choice for gastric MALT lymphoma, leading to complete remission of the lymphoma in the majority of cases. In the absence of success, radiotherapy is available in localized stages I/II E with excellent results. Immuno-chemotherapy is the domain for advanced stages III/IV E, and surgery plays no role any more. The rare intestinal and colorectal MALT lymphomas require an individualized therapeutic approach.
胃肠道黏膜相关淋巴瘤是一组异质性疾病，在发病机制、定位和治疗选择上存在差异。对于所有这些疾病，差异化治疗需要准确确定淋巴瘤分期。对于胃MALT淋巴瘤，幽门螺杆菌感染在过去30年中的致病作用已变得明显。因此，这些见解已被应用于临床实践。如今，根除幽门螺杆菌是胃MALT淋巴瘤的首选治疗方法，在大多数情况下可使淋巴瘤完全缓解。若治疗失败，I/II E期局限性病变可采用放射治疗，效果良好。免疫化疗适用于III/IV E期晚期病变，手术不再起作用。罕见的肠道和结直肠MALT淋巴瘤需要个体化的治疗方法。
