Iwano Masahiro, Okazaki Kazuichi, Uchida Kazushige, Nakase Hiroshi, Ohana Masaya, Matsushima Yumi, Inagaki Hiroshi, Chiba Tsutomu
Department of Gastroenterology and Endoscopic Medicine, Kyoto University Hospital, 54 Shogoin, Sakyo, 606-8507, Kyoto, Japan.
J Gastroenterol. 2004 Aug;39(8):739-46. doi: 10.1007/s00535-004-1382-1.
Mucosa-associated lymphoid tissue (MALT) lymphoma involving multiple organs is not well characterized.
To obtain a better understanding of gastric MALT lymphoma with multiple organ involvement, we compared Helicobacter pylori infection status; response to eradication therapy; prevalence of genetic abnormality, including t(11;18)(q21;q21); and clonality of tumor cells between patients with gastric MALT lymphoma with and without multiple organ involvement.
Of 54 patients with only gastric involvement, 51 were positive for H. pylori (94.4%), whereas only 3 of 9 patients with multiple organ involvement had the infection (33.3%). Among those who received eradication therapy, the remission rate in patients with only gastric involvement was significantly higher than that in patients with multiple organ involvement (71.4% vs 33.3%; P < 0.05). The positive rate of API2-MALT1 fusion transcripts was significantly greater in patients with multiple lesions with either single or multiple organ involvement than in those with a single gastric lesion (71.4% vs 12.5%; P < 0.05), but 2 of 2 patients with multiple gastric lesions had the fusion transcripts. Of 5 patients with multiple organ involvement tested for clonality of the CDR3 region, distinct clones were detected in lymphoma lesions in different organs in 3 patients, whereas the identical clone was present in the different lesions in the remaining 2 patients.
Gastric MALT lymphoma with multiple organ involvement is often associated with API2-MALT1 fusion transcripts. Moreover, H. pylori infection is rare in patients with multiple organ involvement as compared to those with only gastric involvement. Patients with gastric MALT lymphoma with multiple organ involvement who are positive for H. pylori are resistant to eradication therapy.
累及多个器官的黏膜相关淋巴组织（MALT）淋巴瘤的特征尚不明确。
为了更好地了解累及多个器官的胃MALT淋巴瘤，我们比较了幽门螺杆菌感染状况；根除治疗的反应；包括t(11;18)(q21;q21)在内的基因异常的发生率；以及有或无多器官累及的胃MALT淋巴瘤患者之间肿瘤细胞的克隆性。
在仅累及胃的54例患者中，51例幽门螺杆菌检测呈阳性（94.4%），而在9例有多器官累及的患者中只有3例有该感染（33.3%）。在接受根除治疗的患者中，仅累及胃的患者缓解率显著高于有多器官累及的患者（71.4%对33.3%；P<0.05）。有单个或多个器官累及的多发病变患者中API2-MALT1融合转录本的阳性率显著高于单发胃病变患者（71.4%对12.5%；P<0.05），但2例多发胃病变患者中有2例有该融合转录本。在5例接受多器官累及检测CDR3区域克隆性的患者中，3例患者不同器官的淋巴瘤病变中检测到不同克隆，而其余2例患者不同病变中存在相同克隆。
有多器官累及的胃MALT淋巴瘤常与API2-MALT1融合转录本相关。此外，与仅累及胃的患者相比，多器官累及的患者幽门螺杆菌感染少见。有多器官累及且幽门螺杆菌阳性的胃MALT淋巴瘤患者对根除治疗耐药。
