【摘要】 本文对新近关于胃黏膜相关性淋巴瘤(MALT)分子机制的研究进行综述。大约90%的病历中,幽门螺杆菌(HP)感染在疾病的发生起到重要作用。而清除HP作为治疗本病的一线治疗手段,约50%~90%的病例可达到完全缓解。在HP依赖性的病例中,B淋巴细胞和T淋巴细胞协同刺激分子间的相互作用HP等感染后产生的免疫应答引起MALT淋巴瘤的进展。而在非依赖性的病例中,特异性的染色体易位,如t(11;18)/API2-MALT1,产生的致癌产物激活细胞核因子-κB通路,以及肿瘤坏死因子α介导蛋白-3的失活被认为起了到重要作用。最近一项日本的大型多中心研究表明胃MALT淋巴瘤在清除HP后远期疗效得到了明显改善。而对于清除HP后无效的患者治疗方法主要为单用或联合放射治疗、化学治疗、利妥昔单抗免疫治疗等多种治疗方法。考虑到MALT淋巴瘤的缓慢的疾病进展,二线治疗应充分考虑到疾病的临床分期以及扩散范围以制订详细的治疗计划。更多还原

【Abstract】 Recent progress in the research regarding the molecular pathogenesis and management of gastric mucosa associated lymphoid tissue(MALT) lymphoma is reviewed in this article. About 90% of cases,Helicobacter pylori(HP) infection plays very importent role in the pathogenesis. HP eradication is considered as the first-line treatment,which leads to complete disease remission in 50% ~90% MALT lymphoma. In the HP dependent cases,B lymphocyte and T lymphocyte coordinating stimulus intermolecular interactions caused the immune response after HP infection and made the progress of MALT lymphoma. In the dependence of cases,the specific chromosome translocation,such as t(11;18)/API2-MALT1,produce carcinogenic activation of nuclear factor-k B,as well as the inactivation of tumor necrosis factor mediating protein-3. A recent large multicenter study in Japan found gastric MALT lymphoma treated after clearing HP had dramatically improved the long-term curative effect. For invalid patients after the removal of HP,treatment includes invalid or combined radiotherapy and chemotherapy,tituximab immunotherapy and others. slow disease progression,MALT lymphoma In consideration of second-line treatment should be fully considered according to the disease clinical staging and diffusion area to develop a detailed treatment plan.更多还原