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目的探讨胃粘膜相关淋巴组织（ＭＡＬＴ）淋巴瘤与幽门螺杆菌（Ｈｐ）感染的关系和各种不同层次检测方法的诊断价值。方法对３１例ＭＡＬＴ淋巴瘤作Ｇｉｅｍｓａ染色查Ｈｐ、免疫组化染色、半巢式ＰＣＲ扩增进行ＩｇＨ基因重排，检测其单克隆性。以同期胃淋巴细胞性胃炎（ＬＧ）、无关疾病胃粘膜作对照。结果胃ＭＡＬＴ淋巴瘤中Ｈｐ感染率８３．９％，单克隆性重排８７．１％，远高于对照组。但免疫组化染色显示的轻链限制性仅５５．６％。结论ＰＣＲ法检测ＩｇＨ基因重排优于免疫组化染色检测轻链限制性。在ＬＧ中发现２６．９％有单克隆性Ｂ细胞增生，提示ＰＣＲ法敏感性高，可能具有早期诊断价值。
Objective To investigate the relationship between gastric mucosa-associated lymphoid tissue (MALT) lymphoma and Helicobacter pylori (Hp) infection and the diagnostic value of various levels of detection methods. Methods 31 cases of MALT lymphoma were stained with Giemsa and examined for Hp, immunohistochemical staining and semi-nested PCR amplification for IgH gene rearrangement, and their monoclonality was tested. The same period of gastric lymphocytic gastritis (LG), gastric mucosa of unrelated diseases as a control. Results The rate of Hp infection in gastric MALT lymphoma was 83.9%, and the monoclonal rearrangement was 87.1%, which was much higher than that of the control group. However, immunohistochemical staining showed only a 55.6% restriction of the light chain. Conclusion PCR detection of IgH gene rearrangement is superior to immunohistochemical staining for light chain restriction. A 26.9% monoclonal B cell proliferation was found in LG, suggesting that the PCR method has high sensitivity and may have early diagnostic value.