胃肠道黏膜相关淋巴组织淋巴瘤形态特点及与Ki-67表达、幽门螺杆菌感染的关系

The study of the morphologic features and the relationships with the Ki-67 expression and HP in gastrointestinal mucosa-associated lymphoid tissue lymphoma

目的探讨胃肠道黏膜相关淋巴组织(MALT)淋巴瘤形态特点及其与Ki-67表达、幽门螺杆菌(HP)感染的关系。方法观察22例MALT淋巴瘤的组织形态,并用免疫组织化学链菌素-卵白素生物素(SABC法)对其进行CD20,CD79a,CD3,CD45RO,CD23,CD5,CD10及Ki-67标记。采用Warthin-Starry胃幽门螺杆菌染色法对胃MALT淋巴瘤进行HP染色。结果22例MALT淋巴瘤依据组织形态分为低度恶性16例,伴高度转化6例。在低度恶性MALT淋巴瘤和伴高度恶性转化的MALT淋巴瘤两组病例中,Ki-67的阳性表达率分别为43.8%(7/16),83.3%(5/6),其阳性表达率及表达强度差异有统计学意义(P<0.05)。11例胃MALT淋巴瘤HP阳性率81.6%。结论胃肠道黏膜相关淋巴瘤有其独特的病理形态学特点及临床表现,Ki-67在胃肠道MALT淋巴瘤的诊断、组织学分级中具有重要价值;HP的感染与胃MALT淋巴瘤的关系密切。

Objective To approach the morphologic features and the relationship with the Ki-67 expression, helicobacter pylori （HP） in gastrointestinal mucosa-associated lymphoid tissue lymphoma（MALT lymphoma）. Methods The pathologic features of 22 case were studied. The immunohistochemistry were performed using CD20, CD79a, CD3, CD45RO, CD23, CD5, CD10, Ki-67 nuclear proliferative factor to study the tumor cell and HP were stained with Warthin-starry. Results There were the low grade MALT 16 cases and the transformed MALT 6 cases. In low grade MALT lymphoma and transformed MALT lymphoma, the frequency of Ki-67 positivity is 43.8 %（7/16） and 83.3 %（5/6）. The frequency and strongness of Ki-67 positivity was significantly increased as the histological grade advanced （P 〈0.05）. The frequency of HP positivity 11 case in gastro MALT lymphoma is 81.6%. Conclusion The gastrointestinal MALT lymphoma carries special clinicopathologic feature. The Ki-67 have great values in the diagnosis of gastrointestinal MALT lymphoma and grades of histology. The results also show that the gastrointestinal MALT lymphoma had high relationship with HP infection.