16例消化道MALT淋巴瘤的内镜下特点及临床表现

Endoscopic features and clinical manifestations of 16 cases of digestive tract MALT lymphoma

目的探讨消化道黏膜相关淋巴组织型(MALT)淋巴瘤的临床表现以及内镜下特点。方法回顾分析16例明确诊断为MALT淋巴瘤的患者。结果消化道MALT淋巴瘤的好发部位以胃体为主,胃体部10例(62.50%),其次为胃部多部位受累3例(18.75%),胃窦部1例(6.25%),食管1例(6.25%),直肠1例(6.25%)。病变内镜下表现类型以溃疡型多见(8例,50.00%),其次为隆起型(4例,25.00%),平坦糜烂型(3例,18.75%),凹陷型最为少见(1例,6.25%)。幽门螺杆菌(Hp)感染阳性率为75.00%(12/16)。结论消化道MALT淋巴瘤内镜下表现多样。胃MALT淋巴瘤与Hp感染密切相关。溃疡型及隆起型易在内镜检查时发现,但平坦糜烂型及凹陷型由于与其他炎症性疾病难鉴别,很难早期发现,故早期诊断率较低。在临床工作中需提高对年轻患者及早期MALT淋巴瘤患者的重视,以做到早发现、早治疗。

Objective To explore the endoscopic expression characteristics and clinical manifestations of digestive tract MALT lymphoma.Methods The retrospective analysis was performed on 16 cases of MALT lymphoma in our hospital.Results The predilection site of gastric MALT lymphoma was in gastric body,10 cases were in gastric body,accounting for 62.50%,followed by the stomach multiple parts involvement in 3 cases,accounting for 18.75%.One case（6.25%）was located in gastric antrum,1 case（6.25%）in esophagus and 1 case（6.25%）in rectum.The endoscopic performance types of lesions varied,ulcerative type was the most common（8 cases,50.00%）,followed by protrude type（4 cases,25.00%）,flat erosive type（3 cases,18.75%）and umbilicate type（1 case,6.25%）.The infection positive rate of Helicobacter pylori（Hp）was 75.00%（12/16）.Conclusion The manifestations of digestive tract MALT lymphoma are varied.Helicobacter pylori infection is closely related with gastric MALT lymphoma.The ulcer type and uplift type are easily to be found during endoscopic examination,but the plain,erosion and umbilicate types can be very difficult to be early found due to difficult to differentiate with other inflammatory diseases.Therefore,early diagnosis rate is low,and it is needed to pay attention to the young patients and patients with early MALT lymphoma in order to achieve early find,early treatment.