CAJ | 학술논문

目的探讨胃癌同时合并胃黏膜相关淋巴组织(MALT)淋巴瘤患者的临床病理特征和诊治.方法报告1例77岁男性患者因胃镜检查提示胃部双原发肿瘤2012年10月9日就诊于北京肿瘤医院的临床资料及诊治经过.通过应用PubMed和Google Scholer等英文数据库检索1995年以来的相关英文文献,共获得来自12篇文献共计40例胃癌同时合并胃MALT淋巴瘤的患者资料.结果该例患者接受了根治性全胃切除手术,术后病理提示胃体病变符合进展期低分化腺癌,而胃底病变则为低级别胃MALT淋巴瘤.将该例患者与既往报道的40例胃癌同时合并胃MALT淋巴瘤患者合并分析,结果显示,男性占61.0％(25/41),胃癌病灶处于早期者占65.9％(27/41),MALT淋巴瘤为低级别肿瘤者占82.9％(34/41),伴有幽门螺杆菌(Hp)感染者占72.5％(29/40),胃癌与胃MALT淋巴瘤不相邻或独立存在者占60.0％(24/40).治疗方法选择全胃切除术者9例,胃大部分切除术者7例,另有25例治疗情况不明.结论胃癌同时合并胃MALT淋巴瘤临床较为罕见,其胃癌多处于早期,胃MALT淋巴瘤多为低级别肿瘤,常伴有Hp感染,治疗方法主要取决于胃癌的治疗.
목적 탐토위암동시합병위점막상관림파조직(MALT)림파류환자적림상병리특정화진치.방법 보고1례77세남성환자인위경검사제시위부쌍원발종류2012년10월9일취진우북경종류의원적림상자료급진치경과.통과응용PubMed화Google Scholer등영문수거고검색1995년이래적상관영문문헌,공획득래자12편문헌공계40례위암동시합병위MALT림파류적환자자료.결과 해례환자접수료근치성전위절제수술,술후병리제시위체병변부합진전기저분화선암,이위저병변칙위저급별위MALT림파류.장해례환자여기왕보도적40례위암동시합병위MALT림파류환자합병분석,결과현시,남성점61.0％(25/41),위암병조처우조기자점65.9％(27/41),MALT림파류위저급별종류자점82.9％(34/41),반유유문라간균(Hp)감염자점72.5％(29/40),위암여위MALT림파류불상린혹독립존재자점60.0％(24/40).치료방법선택전위절제술자9례,위대부분절제술자7례,령유25례치료정황불명.결론 위암동시합병위MALT림파류림상교위한견,기위암다처우조기,위MALT림파류다위저급별종류,상반유Hp감염,치료방법주요취결우위암적치료.
Objective To investigate the clinical and pathological features of patients with concurrent gastric adenocarcinoma and primary gastric mucosa-associated lymphoid tissue (MALT)lymphoma.Methods A 77-year-old man referred to Beijing Cancer Hospital for the evaluation of two primary cancers of stomach revealed by gastroscope was reported.The English literature was retrieved and analyzed.Results Total gastrectomy was performed.Histological examination confirmed that the gastric body lesion was consistent with advanced poorly differentiated adenocarcinoma,while the lesion at the fundus with low grade MALT lymphoma.A systematic review of literature in English was performed,and 40 similar patients from 12 studies were found.There were 25 males (61.0％).More patients with adenocarcinoma were at early stage (65.9％) and the majority of lymphoma was low grade (82.9％).Furthermore,most of the patients experienced Helicobacter pylori infection (72.5％).As for therapeutic strategy,most of the patients underwent subtotal or total gastrectomy.Conclusions Concurrent gastric adenocarcinoma with MALT lymphoma is rare.The characteristics of these tumors are still unclear.The majority of gastric adenocarcinoma is at early stage,and most of the patients have Helicobacter pylori infection.The treatment is mainly based on gastric adenocarcinoma.