Losacco T, Cagiano R, Bottalico L, Carlaio R G, Prejbeanu R, Vermesan H, Dragulescu S I, Vermesan D, Motoc A, Santacroce L
Dept. of Odontostomatology and Surgery, Medical Faculty, University of Bari, Bari, Italy.
Clin Ter. 2008 Jul-Aug;159(4):239-42.
A number of recent studies have expanded our understanding of Helicobacter pylori (Hp) infection and of the pathogenesis of MALT lymphoma. The purpose of this paper is to perform a retrospective analysis of the clinical characteristics of gastric MALT lymphoma and its relationship with H. pylori infection in authors' experience.
We report nineteen patients observed during 10 years, presenting with gastric MALTomas at any stage. The staging classification and the presence of H. pylori infection have been assessed, and the chosen therapy also.
The most part of our patients underwent surgery, still now resulting the most effective therapy. None of the patients had eradicating therapy due to their poor compliance and because the most part of cases were observed before the time of clinical validation of such treatment.
In our series, surgery was effective for treatment of gastric MALT lymphomas. Surgery and chemotherapy remain, in accord with literature data, the best treatment for gastric MALTomas. Hence, because Hp may play a role in the development of such pathology in certain patients, antibiotic treatment for Hp eradication should not be discouraged in these patients, especially in them with low grade gastric MALT lymphomas. In fact, the failure of this therapy will not modify either survival or later recourse to surgical and/or radio- and chemotherapy.
近期的多项研究拓展了我们对幽门螺杆菌(Hp)感染及黏膜相关淋巴组织淋巴瘤(MALT淋巴瘤)发病机制的认识。本文旨在根据作者的经验,对胃MALT淋巴瘤的临床特征及其与Hp感染的关系进行回顾性分析。
我们报告了在10年间观察到的19例各阶段胃MALT淋巴瘤患者。评估了分期分类、Hp感染情况以及所采用的治疗方法。
我们的大多数患者接受了手术治疗,目前手术仍是最有效的治疗方法。由于患者依从性差且大多数病例是在此类治疗的临床验证时间之前观察到的,所以没有患者接受根除治疗。
在我们的系列研究中,手术对胃MALT淋巴瘤治疗有效。与文献数据一致,手术和化疗仍是胃MALT淋巴瘤的最佳治疗方法。因此,鉴于Hp可能在某些患者的此类病变发展中起作用,不应阻止对这些患者进行根除Hp的抗生素治疗,尤其是对低级别胃MALT淋巴瘤患者。事实上,这种治疗失败既不会改变生存率,也不会影响后续进行手术和/或放化疗。