放大染色内镜对结节性胃炎、胃粘膜相关组织淋巴瘤的诊断

Magnification Chromoendoscopy for the Diagnosis of Nodular Gastritis and Mucosa Associated Lymphoidtissue Lymphorma of Stomach

目的:探讨放大染色内镜对结节性胃炎、胃粘膜相关组织淋巴瘤诊断的可行性。方法:选择哈尔滨医科大学第四临床医学院2007年5月～2010年7月诊断的结节性胃炎、疑诊胃粘膜相关组织淋巴瘤患者,观察临床、内镜、病理表现、幽门螺杆菌感染情况和根除治疗的效果。并应用日本FUJINON EG-590ZW型放大内镜对患者进行检查,观察根除幽门螺杆菌前后结节性胃炎、胃粘膜相关组织淋巴瘤的改变。结果:纳入分析的100例成人患者,男25例,女75例,年龄19～68岁,平均年龄39.2岁。主要临床表现为上腹痛和消化不良症状。内镜下表现为胃窦部为主,可扩展至胃体部的色泽均匀的结节样或颗粒样改变。病理检查显示胃窦部活检标本中有伴生发中心的淋巴滤泡增生。所有患者均有幽门螺杆菌感染,经根除治疗后,症状缓解率达92.0%。结论:结节性胃炎、胃粘膜相关组织淋巴瘤发生与幽门螺杆菌感染相关,放大染色内镜对结节性胃炎有诊断意义。

Objective： To investigate the feasibility of magnification chromo-endoscopy in the diagnosis of mucosa-associated lymphoid tissue lymphoma of stomach（MALT） by eradication of Helicobacter pylori （HP）. Methods： The clinical presentations, magnification chromo-endoscopic and histological findings, Helicobacter pyloroi infection status, the effect of eradication therapy in nodular gastritis and MALT patients were investigated from May 2007 to July 2010 at the fourth clinical Hospital of Harbin Medical University. One hundred patients were examined by magnification chromo-endoscopy to observe the changes of nodular gastritis and MALT by eradication of liP. Results： The mean age of MALT patients enrolled in this study was 39.2 years （19-68 years）, 25 were male and 75 were female. The major clinical manifestations were epigastric pain and dyspeptic symptoms. MALT is characterized by nodular or granular patterns in the antrum and （or） extending to the corpus endoscopically; The patients had germinal center of lymphoid follicle formation in their antral biopsy specimens. All patients were positive for H.pylori infection, and 92 patients （92.0%） were improved after eradication. Conclusions： Nodular gastritis and MALT were caused by H.pylori infection. H.pylori eradication therapy is strongly recommended for patients.