Park Sanghui, Ahn Soomin, Hong Mineui, Ko Young Hyeh
Department of Pathology, Ewha Womans University School of Medicine, Seoul, 07985 Republic of Korea.
Department of Pathology, Ewha Womans University School of Medicine, Seoul, 07985 Republic of Korea.
Hum Pathol. 2017 Jan;59:113-119. doi: 10.1016/j.humpath.2016.09.013. Epub 2016 Sep 30.
Gastric mucosa-associated lymphoid tissue (MALT) lymphoma is a rare extranodal marginal zone B-cell lymphoma that is often associated with plasmacytic differentiation. However, the clinicopathological characteristics of gastric MALT lymphoma with increased plasmacytic differentiation have not yet been studied. To assess the clinicopathological implications of gastric MALT lymphoma with increased plasmacytic differentiation, 36 cases with increased plasmacytic differentiation and a control group of 16 cases with minimal plasmacytic differentiation were retrospectively collected from 65 primary gastric MALT lymphomas (2010-2012). The hematoxylin and eosin slides were reviewed, and IgG, IgG4, and κ and λ immunohistochemical staining was performed. Clinicopathological differences between the 2 groups were compared using the χ test and odds ratios. Logistic regression analyses were used to evaluate resistance to Helicobacter pylori eradication therapy. Increased plasmacytic differentiation is significantly correlated with the H pylori eradication response (94.4% versus 66.7%, P=.018), lower frequency of relapse (5.6% versus 35.7%, P=.014), the presence of more than one IgG4+ cell per high-power field (27.8% versus 0%, P=.022), and light-chain restriction (33.3% versus 6.2%, P=.044). Univariable logistic regression indicated that negative H pylori status (P=.016) and minimal plasmacytic differentiation (P=.019) were statistically significant predictive factors for resistance to H pylori eradication. Multivariable logistic regression analyses identified no statistically significant predictive factors. However, H pylori negativity and minimal plasmacytic differentiation showed a statistical trend toward significance (P=.078 and P=.09). Gastric MALT lymphomas with increased plasmacytic differentiation have different clinicopathological characteristics, and plasmacytic differentiation is associated with H pylori eradication response.
胃黏膜相关淋巴组织（MALT）淋巴瘤是一种罕见的结外边缘区B细胞淋巴瘤，常伴有浆细胞分化。然而，浆细胞分化增加的胃MALT淋巴瘤的临床病理特征尚未得到研究。为了评估浆细胞分化增加的胃MALT淋巴瘤的临床病理意义，我们从65例原发性胃MALT淋巴瘤（2010 - 2012年）中回顾性收集了36例浆细胞分化增加的病例和16例浆细胞分化极少的对照组病例。对苏木精和伊红染色切片进行复查，并进行IgG、IgG4以及κ和λ免疫组化染色。使用χ检验和比值比比较两组之间的临床病理差异。采用逻辑回归分析评估对幽门螺杆菌根除治疗的耐药性。浆细胞分化增加与幽门螺杆菌根除反应显著相关（94.4%对66.7%，P = 0.018），复发频率较低（5.6%对35.7%，P = 0.014），每高倍视野存在一个以上IgG4 +细胞（27.8%对0%，P = 0.022），以及轻链限制（33.3%对6.2%，P = 0.044）。单变量逻辑回归表明，幽门螺杆菌阴性状态（P = 0.016）和极少的浆细胞分化（P = 0.019）是幽门螺杆菌根除耐药的统计学显著预测因素。多变量逻辑回归分析未发现统计学显著的预测因素。然而，幽门螺杆菌阴性和极少的浆细胞分化显示出统计学上的显著趋势（P = 0.078和P = 0.09）。浆细胞分化增加的胃MALT淋巴瘤具有不同的临床病理特征，并且浆细胞分化与幽门螺杆菌根除反应相关。
