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[原发性胃黏膜相关淋巴组织淋巴瘤的发病机制、诊断与治疗的当前研究进展]

[Current aspects of pathogenesis, diagnosis and therapy of primary MALT stomach lymphomas].

作者信息

Fischbach W

机构信息

II. Med. Klinik, Klinikum Aschaffenburg.

出版信息

Z Gastroenterol. 1998 Apr;36(4):307-12.

PMID:9612929
Abstract

Primary gastrointestinal lymphoma of MALT occupy a special position which is documented in their own histological classification. Our knowledge about pathogenesis, biological and therapeutical behaviour of this lymphoma entity has increased substantially during recent years. Considering epidemiological, histomorphological and experimental data Helicobacter pylori infection undoubtless plays an important role in the development and progression of gastric MALT-lymphoma. In view of histological malignancy (low or high grade) and dissemination of the disease (stage) as decisive prognostic factors and therapeutical determinants endoscopic-bioptical diagnosis as well as endoscopic ultrasound are of major importance. In case of localized low-grade lymphoma eradication of Helicobacter pylori offers a promising therapeutic option. Surgical resection and radiochemotherapy have proven to be effective treatment modalities. There is a need for randomized trials to clarify if operative or conservative therapeutic strategies have to be favored in the future.

摘要

黏膜相关淋巴组织原发性胃肠道淋巴瘤占据着特殊地位,这在其自身的组织学分类中有记载。近年来,我们对这种淋巴瘤实体的发病机制、生物学行为及治疗方法的了解有了显著增加。综合流行病学、组织形态学及实验数据来看,幽门螺杆菌感染无疑在胃黏膜相关淋巴组织淋巴瘤的发生和发展中起着重要作用。鉴于组织学恶性程度(低级别或高级别)及疾病播散情况(分期)作为决定性的预后因素和治疗决定因素,内镜活检诊断以及内镜超声检查至关重要。对于局限性低级别淋巴瘤,根除幽门螺杆菌提供了一种有前景的治疗选择。手术切除和放化疗已被证明是有效的治疗方式。需要进行随机试验以明确未来是应倾向于手术还是保守治疗策略。

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