Durr E D, Bonner J A, Strickler J G, Martenson J A, Chen M G, Habermann T M, Donohue J H, Earle J D, Grill J P
Division of Radiation Oncology, Mayo Clinic, Rochester, MN 55905, USA.
Acta Haematol. 1995;94(2):59-68. doi: 10.1159/000203975.
From 1975 to 1991, stage IE gastric lymphoma was diagnosed or treated in 40 patients at our institution. Thirty-five evaluable patients were the subject of this analysis (median age, 63 years). All histologic specimens were reviewed and classified according to the working formulation. Immunohistochemical stains were performed in 33 of 35 cases. The following histologic subtypes were identified: 26 patients had diffuse large cell, 2 had diffuse mixed cell, and 7 had mucosa-associated lymphocytic lymphoma (small lymphocytic lymphoma with features of MALT lymphoma). Of the 35 patients, 30 (86%) underwent laparotomy, with subtotal or total gastrectomy performed in 29. After gastrectomy, 17 patients had radiation therapy, 3 had chemotherapy, 2 had radiation plus chemotherapy, and 7 had no further treatment. Five patients were diagnosed with endoscopic biopsy and had radiation therapy, chemotherapy, or both without further surgical treatment. The median follow-up period was 69.2 months. The commonest presenting symptom was pain. The 5-year disease-free survival was 90% for the entire group and 88% for the 28 patients with working formulation intermediate histology. For patients with MALT lymphoma, the 5-year disease-free survival was 100%. The prognosis for patients with stage IE working formulation intermediate-histology gastric lymphoma is good and for those with stage IE MALT lymphoma, excellent.
1975年至1991年期间，我院共诊断或治疗了40例ⅠE期胃淋巴瘤患者。本分析纳入了35例可评估患者（中位年龄63岁）。所有组织学标本均根据工作分类法进行复查和分类。35例中的33例进行了免疫组织化学染色。确定了以下组织学亚型：26例为弥漫大细胞型，2例为弥漫混合细胞型，7例为黏膜相关淋巴细胞性淋巴瘤（具有MALT淋巴瘤特征的小淋巴细胞淋巴瘤）。35例患者中，30例（86%）接受了剖腹手术，其中29例行胃次全切除术或全胃切除术。胃切除术后，17例患者接受了放射治疗，3例接受了化疗，2例接受了放疗加化疗，7例未接受进一步治疗。5例患者经内镜活检确诊，未进一步手术治疗，仅接受了放疗、化疗或两者皆有。中位随访期为69.2个月。最常见的症状是疼痛。整个组的5年无病生存率为90%，28例工作分类法中级组织学患者的5年无病生存率为88%。MALT淋巴瘤患者的5年无病生存率为100%。ⅠE期工作分类法中级组织学胃淋巴瘤患者的预后良好，ⅠE期MALT淋巴瘤患者的预后极佳。
