Fischbach W, Goebeler-Kolve M-E, Dragosics B, Greiner A, Stolte M
Department of Internal Medicine, Klinikum Aschaffenburg, Aschaffenburg, Germany.
Gut. 2004 Jan;53(1):34-7. doi: 10.1136/gut.53.1.34.
Helicobacter pylori plays a decisive role in the pathogenesis of gastric marginal zone B cell lymphoma of mucosa associated lymphoid tissue (MALT), and eradication therapy has become a widely accepted initial treatment of stage I disease.
To determine the long term outcome of patients undergoing exclusive H pylori eradication therapy.
A prospective series of patients with newly diagnosed marginal zone B cell lymphoma of MALT.
Multicentre study in Germany and Austria.
Ninety five patients; 90 of these (five lost to follow up) with a mean age of 54.3 (27-85) years were followed up for at least 12 months.
Complete staging work up revealing stage I disease and H pylori infection. Patients received triple therapy (OMC: omeprazole 20 mg twice daily, metronidazole 400 mg twice daily, and clarithromycin 250 mg twice daily; or OAC: omeprazole 20 mg twice daily, amoxycillin 1000 mg twice daily, and clarithromycin 500 twice daily) for one week.
Median follow up was 44.6 (12-89) months. H pylori was successfully eradicated in 88 patients (98%); in two patients eradication therapy failed. Long term outcome was characterised by complete regression of lymphoma in 56 patients (62%), minimal residual disease in 17 patients (18%), partial remission in 11 patients (12%), no change in four patients (4%), and progressive disease in two patients (2%). Four patients with complete remission relapsed after 6, 8, 8, and 15 months, one revealing reinfection by H pylori. Regression rate was higher in stage I1 disease compared with stage I2, as diagnosed by endoscopic ultrasound.
The majority of patients with low grade gastric MALT lymphoma treated by exclusive H pylori eradication have a favourable long term outcome, offering a real chance of cure.
幽门螺杆菌在黏膜相关淋巴组织胃边缘区B细胞淋巴瘤（MALT）的发病机制中起决定性作用，根除治疗已成为广泛接受的I期疾病初始治疗方法。
确定接受单纯幽门螺杆菌根除治疗患者的长期预后。
对新诊断的MALT边缘区B细胞淋巴瘤患者进行前瞻性系列研究。
德国和奥地利的多中心研究。
95例患者；其中90例（5例失访）平均年龄54.3岁（27 - 85岁），随访至少12个月。
全面分期检查显示为I期疾病且存在幽门螺杆菌感染。患者接受三联疗法（OMC：奥美拉唑20毫克每日两次、甲硝唑400毫克每日两次、克拉霉素250毫克每日两次；或OAC：奥美拉唑20毫克每日两次、阿莫西林1000毫克每日两次、克拉霉素500毫克每日两次），疗程1周。
中位随访时间为44.6个月（12 - 89个月）。88例患者（98%）幽门螺杆菌成功根除；2例患者根除治疗失败。长期预后表现为56例患者（62%）淋巴瘤完全消退，17例患者（18%）微小残留病，11例患者（12%）部分缓解，4例患者（4%）无变化，2例患者（2%）疾病进展。4例完全缓解患者分别在6、8、8和15个月后复发，1例显示幽门螺杆菌再次感染。经内镜超声诊断，I1期疾病的缓解率高于I2期。
大多数接受单纯幽门螺杆菌根除治疗的低级别胃MALT淋巴瘤患者长期预后良好，提供了真正的治愈机会。
