CAJ | 학술논문

目的:探讨胃黏膜相关淋巴组成淋巴瘤(Mucosa-Associated Lymphoid Tissue,MALT)病理学特征与治疗方法之间的关系,以提高其疗效.方法:选择23例胃MALT淋巴瘤患者,统计其临床症状、内镜形态、病理特点,以及不同治疗方法所产生的疗效.结果:幽门螺杆菌(H.pylori)感染21例,感染率为91.3%;胃窦、胃体多灶性13例(56.5%),胃窦部9例(39.1%);病变局限于胃黏膜及黏膜下层20例(87.0%),侵犯肌层2例(8.7%),侵达浆膜1例(4.3%);21例H.pylori感染者均经质子泵抑制剂(PPI)加克拉霉素加阿莫西林规范治疗,根除H.pylori后2个月复查胃镜,17例(73.9%)病灶完全消失,随访2年内未复发;4例行COP方案化疗,其中3例病灶消退,随访至今未复发;1例出现恶化,1年后死亡.2例H.pylori阴性的巨大溃疡患者直接手术切除,术后均行CHOP方案化疗,随访5年未发现病灶复发.结论:胃MALT淋巴瘤与发病年龄、性别、肿瘤累及部位和体积大小等对生存率没有明显影响,而肿瘤侵犯深度和是否有远处转移与生率存在显著相关性,在不同发展阶段采取正确的治疗方法是提高治愈率的关键.
목적:탐토위점막상관림파조성림파류(Mucosa-Associated Lymphoid Tissue,MALT)병이학특정여치료방법지간적관계,이제고기료효.방법:선택23례위MALT림파류환자,통계기림상증상、내경형태、병리특점,이급불동치료방법소산생적료효.결과:유문라간균(H.pylori)감염21례,감염솔위91.3%;위두、위체다조성13례(56.5%),위두부9례(39.1%);병변국한우위점막급점막하층20례(87.0%),침범기층2례(8.7%),침체장막1례(4.3%);21례H.pylori감염자균경질자빙억제제(PPI)가극랍매소가아막서림규범치료,근제H.pylori후2개월복사위경,17례(73.9%)병조완전소실,수방2년내미복발;4례행COP방안화료,기중3례병조소퇴,수방지금미복발;1례출현악화,1년후사망.2례H.pylori음성적거대궤양환자직접수술절제,술후균행CHOP방안화료,수방5년미발현병조복발.결론:위MALT림파류여발병년령、성별、종류루급부위화체적대소등대생존솔몰유명현영향,이종류침범심도화시부유원처전이여생솔존재현저상관성,재불동발전계단채취정학적치료방법시제고치유솔적관건.
Objective To analysis the pathological characteristic of gastric mucosa-associated lymphoid tissue(MALT) lymphoma.It would improve the cure rate of the disease.Methods Twenty three cases of gastric MALT lymphoma were run by retrospective analysis.To investigate the more effective treatment methods,the cases were summarized with incipient symptoms,features of endoscope,pathology and therapeutic effect.Results The average age of patients is sixty two.Male female ratio is 1.56.Twenty one patients were infected by H.pylori.The positive ratio is 91.3%.The mucous membrane of sinus ventriculi and corpus gastricum showed many parts in 13 patients(56.5%).Mucous membrane of sinus ventriculi existed lymphoma in 9 patients(39.1%).Lesions was confined to the gastric mucosa and submucosa in 20 patients(87.0%). Tumor encroached muscular layer in two patients and serosa in one patient.Twenty one patients with H.pylori infection were treated by the proton pump inhibitor(PPI),Clarithromycin and Amoxicillin.The patients were checked by endoscope after two months when Hp had been eradicated. The lesions of 17 cases(73.9%) completely disappeared.No one recurred for two years.The recurrence did not occur in 3 patients with COP chemotherapy.But one patient deteriorated and died after a year.Two H.pylori-negative patients with the huge ulcer were directly operated and followed CHOP chemotherapy.No one recurred for five years.Conclusion The age of onset,tumor site and size of gastric MALT lymphoma were no significant impact on survival.Tumor invasion depth and metastasis with the survival rate there were a significant correlation.The correct treatment was the key to improve the cure rate in the different stages of development.