Urakami Y, Sano T, Begum S, Endo H, Kawamata H, Oki Y
Department of Gastroenterology, Urakami Gastroenterology Clinic, Tokushima, Japan.
J Gastroenterol Hepatol. 2000 Oct;15(10):1113-9. doi: 10.1046/j.1440-1746.2000.02317.x.
It was recently reported that low-grade gastric lymphoma of mucosa-associated lymphoid tissue (MALT) was regressed by the eradication of Helicobacter pylori. The aim of this study was to confirm the effect of H. pylori eradication on low-grade gastric MALT lymphoma and to investigate the whitish mucosa that appeared with regression of the lesions.
Forty-seven H. pylori-positive patients with low-grade gastric MALT lymphoma were treated by using triple therapy. Biopsy specimens were histologically graded and B cell clonality was examined by using reverse transcription-polymerase chain reaction before and after eradication treatment. The relationship between the appearance of whitish mucosa and the degree of gastric gland loss was evaluated.
Histologic regression was observed 2 months after eradication therapy in 42 of 47 patients. However, B cell monoclonality changed to polyclonality in only 23 patients during the follow-up period. The appearance of whitish mucosa in patients who showed histologic regression became more frequent as the degree of gastric gland loss increased (P< 0.001).
Most low-grade gastric MALT lymphoma histologically regressed after H. pylori eradication. The appearance of whitish mucosa after histologic regression reflected the degree of gastric gland loss. Whitish mucosa is an endoscopic characteristic and may be an endoscopic marker for regression of low-grade gastric MALT lymphoma.
最近有报道称，根除幽门螺杆菌可使黏膜相关淋巴组织（MALT）低度胃淋巴瘤消退。本研究的目的是证实根除幽门螺杆菌对低度胃MALT淋巴瘤的疗效，并研究病变消退时出现的白色黏膜情况。
47例幽门螺杆菌阳性的低度胃MALT淋巴瘤患者采用三联疗法治疗。在根除治疗前后，对活检标本进行组织学分级，并采用逆转录-聚合酶链反应检测B细胞克隆性。评估白色黏膜的出现与胃腺丢失程度之间的关系。
47例患者中有42例在根除治疗2个月后出现组织学消退。然而，在随访期间，只有23例患者的B细胞单克隆性转变为多克隆性。组织学消退患者中白色黏膜的出现随着胃腺丢失程度的增加而更加频繁（P<0.001）。
大多数低度胃MALT淋巴瘤在根除幽门螺杆菌后组织学消退。组织学消退后白色黏膜的出现反映了胃腺丢失的程度。白色黏膜是一种内镜特征，可能是低度胃MALT淋巴瘤消退的内镜标志物。
