Gut · 2001
Predictive value of endoscopic ultrasonography for regression of gastric low grade and high grade MALT lymphomas after eradication of Helicobacter pylori.
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Nakamura S, Matsumoto T, Suekane H, Takeshita M, Hizawa K, Kawasaki M, Yao T, Tsuneyoshi M, Iida M, Fujishima M
Аннотация
BACKGROUND: While a close association between gastric mucosa associated lymphoid tissue (MALT) lymphoma and Helicobacter pylori infection has been established, there are still cases which do not respond to H pylori eradication.
AIMS: To investigate the clinicopathological factors which may help predict the therapeutic efficacy of H pylori eradication in gastric MALT lymphoma.
PATIENTS: Forty one patients with gastric MALT lymphoma, including low and high grade lesions.
METHODS: After endosonographic staging was determined, H pylori was eradicated in all patients, and the subsequent gastric pathological course was then investigated.
RESULTS: Complete regression of MALT lymphoma was observed in 29(71%) patients, partial regression in five (12%), and no regression in seven (17%). Twenty six (93%) of 28 MALT lymphomas restricted to the mucosa but only three (23%) of 13 lymphomas which invaded the deep portion of the submucosa or beyond completely regressed. Kaplan-Meier analysis for the probability of complete regression of MALT lymphoma revealed a significant difference between tumours restricted to the mucosa and those invading the submucosa deeply or beyond (p<0.05). Neither the presence of a high grade component, perigastric lymphadenopathy, nor clinical staging prior to eradication correlated with the probability of lymphoma regression.
CONCLUSIONS: Assessment of deep submucosal invasion by endosonography is valuable for predicting the efficacy of H pylori eradication in gastric MALT lymphoma.
AIMS: To investigate the clinicopathological factors which may help predict the therapeutic efficacy of H pylori eradication in gastric MALT lymphoma.
PATIENTS: Forty one patients with gastric MALT lymphoma, including low and high grade lesions.
METHODS: After endosonographic staging was determined, H pylori was eradicated in all patients, and the subsequent gastric pathological course was then investigated.
RESULTS: Complete regression of MALT lymphoma was observed in 29(71%) patients, partial regression in five (12%), and no regression in seven (17%). Twenty six (93%) of 28 MALT lymphomas restricted to the mucosa but only three (23%) of 13 lymphomas which invaded the deep portion of the submucosa or beyond completely regressed. Kaplan-Meier analysis for the probability of complete regression of MALT lymphoma revealed a significant difference between tumours restricted to the mucosa and those invading the submucosa deeply or beyond (p<0.05). Neither the presence of a high grade component, perigastric lymphadenopathy, nor clinical staging prior to eradication correlated with the probability of lymphoma regression.
CONCLUSIONS: Assessment of deep submucosal invasion by endosonography is valuable for predicting the efficacy of H pylori eradication in gastric MALT lymphoma.
Предметные рубрики MeSH
AdultAgedAged, 80 and overAnti-Bacterial AgentsAnti-Ulcer AgentsDrug Therapy, CombinationFemaleGastroscopyHelicobacter InfectionsHelicobacter pyloriHumansLymphoma, B-Cell, Marginal ZoneMaleMiddle AgedNeoplasm StagingPredictive Value of TestsProspective StudiesRemission InductionStatistics, NonparametricStomach NeoplasmsSurvival AnalysisTreatment OutcomeUltrasonography