Delchier J C, Lamarque D, Levy M, Tkoub E M, Copie-Bergman C, Deforges L, Chaumette M T, Haioun C
Services d'Hépatologie, Hôpital Henri Mondor, Créteil, France.
Am J Gastroenterol. 2001 Aug;96(8):2324-8. doi: 10.1111/j.1572-0241.2001.04036.x.
Gastric lymphoma of mucosa-associated lymphoid tissue (MALT) type is closely related to Helicobacter pylori (H. pylori) infection. In vitro studies have demonstrated H. pylori-induced B cell proliferation to be strain dependent. High prevalences of CagA protein and FldA protein have been reported in strains obtained from patients with gastric lymphoma of MALT type. The aims of the present study were to evaluate the prevalence of H. pylori infection and to search for antigenic particularities in 53 patients with primary gastric lymphoma in comparison with a group of infected patients with benign disease.
Of the 53 patients, 37 presented with low-grade lymphoma of MALT type (LGLM) and 16 with diffuse large B-cell lymphoma (DLBCL). They were compared to a group of 162 H. pylori-infected subjects comprising the control group: 111 had gastric or duodenal ulcer (GDU) and 51 nonulcer dyspepsia (NUD). Diagnosis of gastric lymphoma was established on histological examination of endoscopic specimens. Anti-H. pylori antibodies were assayed by third-generation ELISA. Western blot assay was used to detect antibodies against nine antigens (including CagA protein), which were recognized on the basis of their molecular weight.
Of the 53 patients with gastric lymphoma, 45 were H. pylori-positive (85%): of these, 25 (56.5%) had anti-CagA antibodies. The prevalence of H. pylori seropositivity was 78% (29/37) in LGLM and 100% (16/16) in DLBCL. The prevalence of CagA seropositivity in H. pylori-positive patients was 44.8% (13/29) and 75% (12/16), respectively (p < 0.05). In comparison, the seroprevalence of CagA was 77.4% (86/111) in GDU patients and 43.1% (22/53) in NUD patients. The prevalence of antibodies to other antigenic proteins detected with Helicoblot 2.0 (19.5kd, 30kd, 35kd, VacA, HSPb, Urease A, and Urease B) did not differ among the groups except for 35kd protein, which was significantly higher (p < 0.01) in GDU than in NUD and in LGLM (76.6% vs 49% and 46.7%).
These findings suggest that in patients who develop gastric lymphomas in response to H. pylori, virulent strains expressing CagA protein are preferentially associated with DLBCL.
黏膜相关淋巴组织（MALT）型胃淋巴瘤与幽门螺杆菌（H. pylori）感染密切相关。体外研究表明，H. pylori诱导的B细胞增殖具有菌株依赖性。据报道，从MALT型胃淋巴瘤患者分离出的菌株中，CagA蛋白和FldA蛋白的阳性率较高。本研究的目的是评估53例原发性胃淋巴瘤患者中H. pylori感染的患病率，并与一组感染良性疾病的患者进行比较，寻找抗原特异性。
53例患者中，37例为MALT型低度淋巴瘤（LGLM），16例为弥漫性大B细胞淋巴瘤（DLBCL）。将他们与162例H. pylori感染的受试者组成的对照组进行比较：111例患有胃或十二指肠溃疡（GDU），51例患有非溃疡性消化不良（NUD）。通过内镜标本的组织学检查确诊胃淋巴瘤。采用第三代酶联免疫吸附测定法（ELISA）检测抗H. pylori抗体。蛋白质印迹法用于检测针对9种抗原（包括CagA蛋白）的抗体，根据其分子量进行识别。
53例胃淋巴瘤患者中，45例H. pylori阳性（85%）：其中25例（56.5%）有抗CagA抗体。LGLM中H. pylori血清阳性率为78%（29/37），DLBCL中为100%（16/16）。H. pylori阳性患者中CagA血清阳性率分别为44.8%（13/29）和75%（12/16）（p<0.05）。相比之下，GDU患者中CagA血清阳性率为77.
