Kuo Sung-Hsin, Yeh Kun-Huei, Lin Chung-Wu, Liou Jyh-Ming, Wu Ming-Shiang, Chen Li-Tzong, Cheng Ann-Lii
Department of Oncology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei 100, Taiwan.
Cancer Research Center, National Taiwan University College of Medicine, Taipei 100, Taiwan.
Cancers (Basel). 2022 Feb 16;14(4):1005. doi: 10.3390/cancers14041005.
(HP)-unrelated mucosa-associated lymphoid tissue (MALT) lymphoma includes the majority of extragastric MALT lymphomas and a small proportion of gastric MALT lymphomas. Although the role of first-line antibiotics in treating HP-negative gastric MALT lymphomas remains controversial, HP eradication therapy (HPE)-like regimens may result in approximately 20-30% complete remission (CR) for patients with localized HP-negative gastric MALT lymphoma. In these patients, . , , and were detected in sporadic gastric biopsy specimens. Extragastric MALT lymphoma is conventionally treated with radiotherapy for localized disease and systemic chemotherapy for advanced and metastatic diseases. However, a proportion of extragastric MALT lymphomas, such as ocular adnexal lesions and small intestinal lesions, were reported to be controlled by antibiotics for and , respectively. Some extragastric MALT lymphomas may even respond to first-line HPE. These findings suggest that some antibiotic-responsive tumors may exist in the family of HP-negative MALT lymphomas. Two mechanisms underlying the antibiotic responsiveness of HP-negative MALT lymphoma have been proposed. First, an HPE-like regimen may eradicate the antigens of unknown bacteria. Second, clarithromycin (the main component of HPE) may have direct or indirect antineoplastic effects, thus contributing to the CR of these tumors. For antibiotic-unresponsive HP-negative MALT lymphoma, high-dose macrolides and immunomodulatory drugs, such as thalidomide and lenalidomide, have reported sporadic success. Further investigation of new treatment regimens is warranted.
幽门螺杆菌（HP）无关的黏膜相关淋巴组织（MALT）淋巴瘤包括大多数胃外MALT淋巴瘤和一小部分胃MALT淋巴瘤。尽管一线抗生素在治疗HP阴性胃MALT淋巴瘤中的作用仍存在争议，但类似幽门螺杆菌根除治疗（HPE）的方案可能使局限性HP阴性胃MALT淋巴瘤患者的完全缓解率达到约20% - 30%。在这些患者的散发性胃活检标本中检测到了…… 胃外MALT淋巴瘤传统上对于局限性疾病采用放疗，对于晚期和转移性疾病采用全身化疗。然而，据报道，一部分胃外MALT淋巴瘤，如眼附属器病变和小肠病变，分别通过抗生素治疗……得到了控制。一些胃外MALT淋巴瘤甚至可能对一线HPE有反应。这些发现表明，在HP阴性MALT淋巴瘤家族中可能存在一些对抗生素有反应的肿瘤。已经提出了HP阴性MALT淋巴瘤对抗生素有反应的两种机制。首先，类似HPE的方案可能根除未知细菌的抗原。其次，克拉霉素（HPE的主要成分）可能具有直接或间接的抗肿瘤作用，从而促成这些肿瘤的完全缓解。对于对抗生素无反应的HP阴性MALT淋巴瘤，高剂量大环内酯类药物和免疫调节药物，如沙利度胺和来那度胺，已报道有零星的成功案例。有必要进一步研究新的治疗方案。
