Gastroenterology and Digestive Endoscopy, Nuovo Regina Margherita Hospital, Rome, Italy.
Clin Gastroenterol Hepatol. 2010 Feb;8(2):105-10. doi: 10.1016/j.cgh.2009.07.017. Epub 2009 Jul 22.
BACKGROUND & AIMS: Different remission rates of gastric low-grade, B-cell, mucosa-associated lymphoid tissue (MALT) lymphoma have been reported after Helicobacter pylori eradication. We assessed the long-term remission and relapse rates of early stage MALT lymphoma in patients treated only by H pylori eradication and identified factors that might predict outcome.
This systematic review analyzed data from 32 studies, including 1408 patients.
The MALT lymphoma remission rate was 77.5% (95% confidence interval, 75.3-79.7), and was significantly higher in patients with stage I than stage II(1) lymphoma (78.4% vs 55.6%; P = .0003) and in Asian than in Western groups (84.1% vs 73.8%; P = .0001). Neoplasia confined to the submucosa regressed more frequently than that with deeper invasion (82.2% vs 54.5%; P = .0001); patients with lymphoma localized to the distal stomach experienced regression more frequently than those with lymphoma of the proximal stomach (91.8% vs 75.7%; P = .0037). The remission rate was higher among patients without the API2-MALT1 translocation than in those with this translocation (78% vs 22.2%; P = .0001). In an analysis of data from 994 patients, 7.2% experienced lymphoma relapse during 3253 patient-years of follow-up evaluation, with a yearly recurrence rate of 2.2%. Infection and lymphoma were cured by additional eradication therapy in all patients with H pylori recurrence (16.7%). Five (0.05%) of the patients initially cured of lymphoma developed high-grade lymphoma within 6 to 25 months of therapy.
H pylori eradication is effective in treating approximately 75% of patients with early stage gastric lymphoma. Long-term follow-up evaluation of these patients is needed to detect early lymphoma relapse or progression.
幽门螺杆菌（H. pylori）根除后，胃低级别、B 细胞、黏膜相关淋巴组织（MALT）淋巴瘤的缓解率不同。我们评估了仅接受 H. pylori 根除治疗的早期 MALT 淋巴瘤患者的长期缓解和复发率，并确定了可能预测结局的因素。
本系统评价分析了来自 32 项研究的数据，共纳入 1408 例患者。
MALT 淋巴瘤的缓解率为 77.5%（95%置信区间，75.3%79.7%），Ⅰ期患者显著高于Ⅱ期（1）患者（78.4% vs. 55.6%；P=0.0003），亚洲患者显著高于西方患者（84.1% vs. 73.8%；P=0.0001）。局限于黏膜下的肿瘤比侵犯更深的肿瘤更易消退（82.2% vs. 54.5%；P=0.0001）；胃远端的肿瘤比胃近端的肿瘤更易消退（91.8% vs. 75.7%；P=0.0037）。无 API2-MALT1 易位的患者缓解率高于有该易位的患者（78% vs. 22.2%；P=0.0001）。在对 994 例患者数据的分析中，994 例患者中有 7.2%在 3253 患者年的随访评估中出现淋巴瘤复发，年复发率为 2.2%。所有 H. pylori 复发的患者（16.7%）均通过再次根除治疗治愈了感染和淋巴瘤。在接受治疗后 625 个月，有 5 例（0.05%）最初治愈的淋巴瘤患者发展为高级别淋巴瘤。
H. pylori 根除治疗早期胃淋巴瘤的有效率约为 75%。需要对这些患者进行长期随访评估，以发现早期淋巴瘤复发或进展。
