幽门螺杆菌感染性胃炎和胃边缘区淋巴瘤病理诊断及临床治疗进展：附病例报告

Current pathologic diagnosis and management of Helicobacter pylori-associated gastritis and gastric marginal zone lymphoma with a case report

幽门螺杆菌（HP）性胃炎是人类常见的感染性疾病之一.胃黏膜相关淋巴组织淋巴瘤（MALT淋巴瘤）是一种罕见的肿瘤性疾病,与HP的感染有关,也是第一个能用抗生素治愈的人类肿瘤.胃镜活组织检查组织学分析、免疫组织化学标记和分子生物学B细胞克隆性研究是诊断胃MALT淋巴瘤的有效方法.早期胃MALT淋巴瘤首选抗HP治疗.局部放射治疗对于抗生素治疗无效的病例非常有效.系统化疗适用于晚期胃MALT淋巴瘤或大细胞转化的淋巴瘤.文章以一例反复发作的胃MALT淋巴瘤患者为线索,回顾了该病的病理诊断和治疗方面的最新进展.

Helicobacter pylori （H.pylori） associated gastritis is one of the most common infectious diseases in China and worldwide.Gastric marginal zone lymphoma,or mucosa associated lymphoid tissue （MALT） lymphoma is a rare neoplasm associated with H.pylori infection and the first neoplastic disease curable by antibiotics therapy alone.The pathologic diagnosis of gastric MALT lymphoma can be reached by histologic examination,immunohistochemical staining,and B-cell clonality studies.Eradication against H.pylori is the choice of therapy for early stage gastric MALT lymphoma.Refractory,localized disease may be treated with low-dose irradiation therapy with high rates of responding and long-term survival.Systemic chemotherapy is recommended for advanced stage gastric MALT lymphoma or high-grade transformed large B-cell lymphoma.A recent case with recurrent chronic active gastritis and gastric MALT lymphoma after H.pylori eradication therapy was reported.Recent advances in the studies of pathologic diagnosis and therapy of the disease were reviewed.