内窥镜符号学,非霍奇金原发性胃部淋巴结的胃癌。

Валерия Витальевна Лозовая, О. А. Малихова, А. О. Туманян
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摘要

的目标。探讨胃炎样原发性胃非霍奇金淋巴瘤(NHL)的主要内镜差异特征。 材料,方法。本前瞻性研究分析了43例原发性胃NHL患者的复杂内镜诊断结果。2019年至2023年,他们在NN Blokhin国家医学癌症研究中心接受了检查和治疗。患者年龄30 ~ 70岁,50岁以上患者居多,占79% (n = 34)。有33名女性和10名男性。对照组为胃炎样胃恶性肿瘤:腺癌和印戒细胞癌45例;结果。形态学分析显示90.7% (n = 39)诊断为malt淋巴瘤,9.3% (n = 4)诊断为弥漫性大b细胞淋巴瘤。与白光模式检查相比,复杂内镜诊断的澄清方法的灵敏度、特异性和准确性明显更高。根据复杂内镜分析结果,将所有患者分为不同类型幽门螺杆菌致萎缩性胃炎4组(n = 10;23.25%),糜烂性胃炎(n = 10;23.25%)、增生性胃炎(n = 8;18.6%),合并胃炎(n = 15;34.9%)。重点是鉴别胃炎样原发性胃NHL与其他恶性肿瘤病变的主要内镜差异特征。 结论。采用4种具体的内镜诊断澄清方法进行复杂的检查,对于正确解释所发现的变化,及时诊断原发性胃NHL的胃炎样形态是必不可少的。这些包括窄带成像(NBI/BLI和LCI),近焦和放大检查,窄带成像和放大检查相结合,以及超声检查。
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Эндоскопическая семиотика гастритоподобной формы первичных неходжкинских лимфом желудка
Aim. To characterize the main differentially significant endoscopic features specific to the gastritis-like form of primary gastric non-Hodgkin lymphomas (NHL). Materials & Methods. This prospective study analyzes the results of complex endoscopic diagnosis in 43 patients with primary gastric NHL. They were examined and treated at the NN Blokhin National Medical Cancer Research Center from 2019 to 2023. The patients were 30–70 years of age, those over the age of 50 predominated and accounted for 79 % (n = 34). There were 33 women and 10 men. The control group included 45 patients with gastritis-like malignant gastric tumors: adenocarcinoma and signet-ring cell cancer. Results. The morphological analysis yielded a diagnosis of MALT-lymphoma in 90.7 % (n = 39) and diffuse large B-cell lymphoma in 9.3 % (n = 4) of cases. Sensitivity, specificity, and accuracy of the clarification methods of complex endoscopic diagnosis were considerably higher compared to white-light mode examination. According to the results of complex endoscopic analysis, all patients were stratified into 4 groups with different types of H. pylori-induced atrophic gastritis (n = 10; 23.25 %), erosive gastritis (n = 10; 23.25 %), hyperplastic gastritis (n = 8; 18.6 %), and combined gastritis (n = 15; 34.9 %). The focus was laid on identifying the main differentially significant endoscopic features specific to the gastritis-like form of primary gastric NHL which distinguish it from the lesions in other malignant tumors. Conclusion. The complex examination using 4 concrete clarification methods of endoscopic diagnosis is indispensable to properly interpret the detected changes and timely diagnose the gastritis-like form of primary gastric NHL. These include narrow-band imaging (NBI/BLI and LCI), close-focus and magnification examinations, combined narrow-band imaging and magnification examination, as well as endosonography.
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审稿时长
12 weeks
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