摘要
目的探讨胃癌同时合并胃黏膜相关淋巴组织（MALT）淋巴瘤患者的临床病理特征和诊治。方法报告1例77岁男性患者因胃镜检查提示胃部双原发肿瘤2012年10月9日就诊于北京肿瘤医院的临床资料及诊治经过。通过应用PubMed和GoogleScholer等英文数据库检索1995年以来的相关英文文献．共获得来自12篇文献共计40例胃癌同时合并胃MALT淋巴瘤的患者资料。结果该例患者接受了根治性全胃切除手术，术后病理提示胃体病变符合进展期低分化腺癌，而胃底病变则为低级别胃MALT淋巴瘤。将该例患者与既往报道的40例胃癌同时合并胃MALT淋巴瘤患者合并分析，结果显示，男性占61．O％（25／41），胃癌病灶处于早期者占65．9％（27／41），MALT淋巴瘤为低级别肿瘤者占82．9％（34／41），伴有幽门螺杆菌（却）感染者占72．5％（29／40），胃癌与胃MALT淋巴瘤不相邻或独立存在者占60．0％（24／40）。治疗方法选择全胃切除术者9例，胃大部分切除术者7例，另有25例治疗情况不明。结论胃癌同时合并胃MALT淋巴瘤临床较为罕见，其胃癌多处于早期，胃MALT淋巴瘤多为低级别肿瘤，常伴有耶感染，治疗方法主要取决于胃癌的治疗。
Objective To investigate the clinical and pathological features of patients with concurrent gastric adenocarcinoma and primary gastric mucosa-associated lymphoid tissue （MALT） lymphoma. Methods A 77-year-old man referred to Beijing Cancer Hospital for the evaluation of two primary cancers of stomach revealed by gastroscope was reported. The English literature was retrieved and analyzed. Results Total gastrectomy was performed. Histological examination confirmed that the gastric body lesion was consistent with advanced poorly differentiated adenocarcinoma, while the lesion at the fundus with low grade MALT lymphoma. A systematic review of literature in English was performed, and 40 similar patients from 12 studies were found. There were 25 males （61.0%）. More patients with adenocarcinoma were at early stage （65.9%） and the majority of lymphoma was low grade （82.9%）. Furthermore, most of the patients experienced Helicobacter pylori infection （72.5%）. As for therapeutic strategy, most of the patients underwent subtotal or total gastrectomy. Conclusions Concurrent gastric adenocarcinoma with MALT lymphoma is rare. The characteristics of these tumors are still unclear. The majority of gastric adenocarcinoma is at early stage, and most of the patients have Helicobacter pylori infection. The treatment is mainly based on gastric adenocarcinoma.
出处
《中华胃肠外科杂志》
CAS
CSCD
2014年第2期150-154,共5页
Chinese Journal of Gastrointestinal Surgery
基金
国家自然科学基金（81272766）
首都临床特色应用研究（Z121107001012130）
关键词
胃腺癌
胃黏膜相关淋巴组织淋巴瘤
同时性
文献复习
Gastric adenocarcinoma
Gastric mucosa-associated lymphoid tissue lymphoma
Simultaneous occurrence
Literature review
