Hong Seong Soo, Jung Hwoon-Yong, Choi Kee Don, Song Ho June, Lee Gin Hyug, Oh Tae Hoon, Jo Ji-Yun, Kim Kyu-Jong, Byeon Jeong-Sik, Myung Seung-Jae, Yang Suk-Kyun, Hong Weon-Seon, Kim Jin-Ho, Min Young Il
Division of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Songpa-Gu, Seoul, Korea.
Helicobacter. 2006 Dec;11(6):569-73. doi: 10.1111/j.1523-5378.2006.00460.x.
Primary gastric low-grade B-cell lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) is known to be successfully treated with anti-Helicobacter pylori (H. pylori) therapy alone. However, there are few reports on long-term results after eradication therapy. The aims of this study were to analyze the rate and the interval to reach complete remission (CR), and to assess the rate and the factors affecting recurrence of MALT lymphoma.
Between 1996 and 2003, a total of 90 H. pylori-infected patients with low-grade MALT lymphoma were included in this study. For initial staging, endoscopic ultrasonography, chest-abdomen-pelvis CT scans, and bone marrow examination were taken. All patients were made to take anti-H. pylori therapy for 14 days. Tumoral response was assessed by endoscopy every 3 months till CR and every 6 months after achieving CR.
Among 90 treated patients, 85 (94.4%) reached CR. The median interval to CR was 3 months (range, 1-24). Seventy-nine (92.9%) patients were in CR at 12 months. Median follow-up period after CR was 45 months (range 15-109). Among 77 patients who were followed-up after CR, 8 (10.4%) patients were proved with recurrence of MALT lymphoma. Cumulative recurrence rate was 2.7, 11.5, and 12.2% at 1, 2, and 3 years. The presence of H. pylori was only a significant risk factor affecting recurrence.
The status of H. pylori is the most important risk factor affecting recurrence. Therefore, adequate eradication regimen and accurate regular evaluation for H. pylori status are needed during follow up of primary gastric low-grade B-cell MALT lymphoma.
原发性胃黏膜相关淋巴组织低度B细胞淋巴瘤（MALT淋巴瘤）已知单独采用抗幽门螺杆菌（H. pylori）治疗即可成功治愈。然而，关于根除治疗后的长期结果报道较少。本研究的目的是分析达到完全缓解（CR）的率和间隔时间，并评估MALT淋巴瘤的复发率及影响复发的因素。
1996年至2003年期间，本研究共纳入90例感染H. pylori的低度MALT淋巴瘤患者。进行初始分期时，采用了内镜超声检查、胸腹部盆腔CT扫描和骨髓检查。所有患者均接受14天的抗H. pylori治疗。每3个月通过内镜评估肿瘤反应直至达到CR，达到CR后每6个月评估一次。
在90例接受治疗的患者中，85例（94.4%）达到CR。达到CR的中位间隔时间为3个月（范围1 - 24个月）。79例（92.9%）患者在12个月时处于CR状态。CR后的中位随访期为45个月（范围15 - 109个月）。在77例CR后接受随访的患者中，8例（10.4%）患者被证实MALT淋巴瘤复发。1年、2年和3年的累积复发率分别为2.7%、11.5%和12.2%。H. pylori的存在是影响复发的唯一显著危险因素。
H. pylori状态是影响复发的最重要危险因素。因此，在原发性胃低度B细胞MALT淋巴瘤的随访期间，需要适当的根除方案并准确定期评估H. pylori状态。
