Ohnita Ken, Isomoto Hajime, Mizuta Yohei, Maeda Takahiro, Haraguchi Masuho, Miyazaki Masanobu, Murase Kunihiko, Murata Ikuo, Tomonaga Masao, Kohno Shigeru
Second Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki, Japan.
Cancer. 2002 Mar 1;94(5):1507-16. doi: 10.1002/cncr.10367.
Gastrointestinal involvement is seen frequently in patients with adult T-cell leukemia/lymphoma (ATLL). The authors previously showed a relatively low prevalence of Helicobacter pylori infection in individuals with human T-cell lymphotropic virus 1 (HTLV-1) infection, including patients with ATLL; however, the correlation between H. pylori infection and ATLL gastric involvement has not been investigated.
The authors studied 71 patients with ATLL. Gastric involvement was confirmed by endoscopy and biopsy. H. pylori infection was detected by serology, rapid urease test, and immunohistochemistry on biopsy samples. The expression of adhesion molecules on ATLL cells or their ligands on the vasculature in gastric mucosa was analyzed immunohistochemically. The expression of mucosal addressin cell adhesion molecule 1 (MAdCAM-1) was detected by reverse transcriptase-polymerase chain reaction (RT-PCR) analysis.
Gastric involvement was detected in 21 patients (30%), including 8 patients with acute clinical subtype ATLL and 13 patients with lymphoma type ATLL. The prevalence of H. pylori infection was 86% (18 of 21 patients) in the patients with gastric involvement but only 38% (19 of 50 patients) in the patients without such involvement (P < 0.001). The expression of lymphocyte function-associated antigen 1 (LFA-1) and its ligand, intercellular adhesion molecule 1 (ICAM-1), was most frequent on ATLL cells infiltrating the stomach and was enhanced substantially on vascular endothelium in H. pylori-infected gastric mucosa. Human mucosal lymphocyte antigen 1 also was expressed on infiltrating ATLL cells in the stomach. The expression of MAdCAM-1 mRNA assessed by RT-PCR also was seen selectively in H. pylori-infected patients.
ATLL cells infiltrate gastric tissues infected with H. pylori, probably through the interaction of adhesion molecules on these cells and their ligands on the vasculature, i.e., through the LFA-1/ICAM-1 pathway.
胃肠道受累在成人T细胞白血病/淋巴瘤（ATLL）患者中很常见。作者之前发现，在包括ATLL患者在内的人类T细胞嗜淋巴细胞病毒1型（HTLV-1）感染者中，幽门螺杆菌感染的患病率相对较低；然而，幽门螺杆菌感染与ATLL胃受累之间的相关性尚未得到研究。
作者研究了71例ATLL患者。通过内镜检查和活检确认胃受累情况。通过血清学、快速尿素酶试验以及对活检样本进行免疫组织化学检测幽门螺杆菌感染情况。对胃黏膜中ATLL细胞上的黏附分子或其在血管系统上的配体表达进行免疫组织化学分析。通过逆转录聚合酶链反应（RT-PCR）分析检测黏膜地址素细胞黏附分子1（MAdCAM-1）的表达。
21例患者（30%）检测到胃受累，其中包括8例急性临床亚型ATLL患者和13例淋巴瘤型ATLL患者。胃受累患者中幽门螺杆菌感染的患病率为86%（21例患者中的18例），而无胃受累患者中仅为38%（50例患者中的19例）（P<0.001）。淋巴细胞功能相关抗原1（LFA-1）及其配体细胞间黏附分子1（ICAM-1）的表达在浸润胃的ATLL细胞上最为常见，并且在幽门螺杆菌感染的胃黏膜血管内皮上显著增强。人黏膜淋巴细胞抗原1也在胃中浸润的ATLL细胞上表达。通过RT-PCR评估的MAdCAM-1 mRNA表达也仅在幽门螺杆菌感染的患者中选择性出现。
ATLL细胞可能通过这些细胞上的黏附分子与其在血管系统上的配体相互作用，即通过LFA-1/ICAM-1途径浸润感染幽门螺杆菌的胃组织。
