Zucca Emanuele, Cavalli Franco
Department of Medical Oncology, Oncology Institute of Southern Switzerland, Ospedale San Giovanni, Bellinzona, Switzerland.
Curr Hematol Rep. 2004 Jan;3(1):11-6.
There is compelling evidence supporting the link between Helicobacter pylori infection and gastric mucosa-associated lymphoid tissue (MALT) lymphoma, and it seems undeniable that eradication of H. pylori with antibiotics can be effectively used as the sole initial treatment of localized (ie, confined to the gastric wall) gastric MALT lymphoma. This treatment is the best studied therapeutic approach, with more than 20 reported studies confirming that histologic regression of the lymphoma can be achieved in most cases. However, antibiotic treatments seem to suppress but not eradicate the neoplastic clone, and MALT lymphoma relapses have been seen years after treatment. Molecular follow-up studies revealed the persistence of the malignant clone in more than 50% of the cases in histologic remission after antibiotic therapy. The clinical significance of this finding is still unclear. Transient and self-limiting histologic and molecular relapses can also occur. Therefore, a careful long-term follow-up is mandatory for all of the patients who received antibiotic treatment.
有令人信服的证据支持幽门螺杆菌感染与胃黏膜相关淋巴组织（MALT）淋巴瘤之间的联系，而且使用抗生素根除幽门螺杆菌似乎可以有效地作为局限性（即局限于胃壁）胃MALT淋巴瘤的唯一初始治疗方法，这一点似乎无可否认。这种治疗方法是研究得最为充分的治疗手段，超过20项已发表的研究证实，大多数情况下淋巴瘤的组织学消退是可以实现的。然而，抗生素治疗似乎只是抑制而非根除肿瘤克隆，并且在治疗数年之后可见MALT淋巴瘤复发。分子随访研究显示，在抗生素治疗后组织学缓解的病例中，超过50%存在恶性克隆的持续存在。这一发现的临床意义仍不明确。也可能发生短暂的、自限性的组织学和分子复发。因此，对于所有接受抗生素治疗的患者，必须进行仔细的长期随访。
