Schaberg Kurt B, Evans Mark F, Wilcox Rebecca, Lewis Michael R
Department of Pathology and Laboratory Medicine, University of Vermont, Burlington, VT.
Department of Pathology and Laboratory Medicine, University of Vermont, Burlington, VT.
Ann Diagn Pathol. 2015 Dec;19(6):397-402. doi: 10.1016/j.anndiagpath.2015.10.001. Epub 2015 Oct 22.
Helicobacter pylori status influences the prognosis and management of gastric extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma), so accurate determination of H pylori status is of clinical importance. The low rate of histologic H pylori positivity among gastric MALT lymphoma cases at our institution prompted investigation for possible causes. A case series of 24 patients as having gastric MALT lymphoma (with no diffuse large B-cell component) in a tertiary care setting between 1997 and 2010 was identified, and clinical records were reviewed. Immunohistochemical staining for H pylori and BCL10 was performed. This study received institutional review board approval (protocol number M13-033). Thirty-nine percent of cases (9/23) were H pylori positive by histology, and 4 additional patients had positive serologic results; overall, 57% of cases (13/23) were positive for H pylori. Treatment with antisecretory medications was associated with a lower likelihood of histologic positivity (13% among treated patients vs 75% among untreated; P = .04). Nuclear localization of BCL10 was seen in 2 cases and was not associated with H pylori status. Antisecretory medications decrease the likelihood of histologic detection of H pylori in gastric MALT lymphoma cases. Incorporation of results of serologic or other testing is needed to ensure correct classification with respect to H pylori status.
幽门螺杆菌状态会影响胃黏膜相关淋巴组织结外边缘区淋巴瘤（MALT淋巴瘤）的预后和治疗，因此准确确定幽门螺杆菌状态具有临床重要性。在我们机构的胃MALT淋巴瘤病例中，组织学幽门螺杆菌阳性率较低，这促使我们对可能的原因进行调查。我们确定了1997年至2010年间在三级医疗环境中24例患有胃MALT淋巴瘤（无弥漫性大B细胞成分）的病例系列，并对临床记录进行了回顾。进行了幽门螺杆菌和BCL10的免疫组织化学染色。本研究获得了机构审查委员会的批准（方案编号M13 - 033）。39%的病例（9/23）组织学检查幽门螺杆菌呈阳性，另有4例患者血清学结果为阳性；总体而言，57%的病例（13/23）幽门螺杆菌呈阳性。使用抗分泌药物治疗与组织学阳性的可能性较低相关（治疗患者中为13%，未治疗患者中为75%；P = 0.04）。2例病例中观察到BCL10的核定位，且与幽门螺杆菌状态无关。抗分泌药物会降低胃MALT淋巴瘤病例中组织学检测到幽门螺杆菌的可能性。需要纳入血清学或其他检测结果，以确保关于幽门螺杆菌状态的正确分类。
