Haematology Department, A. Tortora Hospital, Pagani, Salerno, Italy.
Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland.
Curr Opin Oncol. 2022 Sep 1;34(5):454-463. doi: 10.1097/CCO.0000000000000886. Epub 2022 Jul 25.
The first convincing evidence for a causal relationship between bacterial infection and lymphomagenesis came from the link between gastric lymphoma and chronic Helicobacter pylori gastritis. This review will summarize the current epidemiological, clinical, and biological evidence of a causative role of bacteria in the development of malignant lymphomas, particularly, the extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue type.
Other microorganisms have been associated with specific extranodal lymphoma sites with variable and not always definitive, evidence, including Chlamydia psittaci , Borrelia burgdorferi , Campylobacter jejuni and, most recently, Coxiella Burnetii . According to most plausible models, lymphoma growth is a consequence of continuous antigenic stimulation induced by chronic infection. However, some evidence of a direct oncogenic role of H. pylori has been provided, too.
Lymphomas are not the result of a single cause but multifactorial diseases, influenced by a variety of genetic and environmental elements. Hence, ascertaining the specific contribution of bacterial infections is not always easy. Nevertheless, the eradication of the associated chronic infection may result in sustained lymphoma regression. Moreover, the association between infections and lymphoma may offer opportunities for reducing lymphoma incidence by preventing the predisposing infections or treating them early.
细菌感染与淋巴瘤发生之间存在因果关系的首个令人信服的证据来自于胃淋巴瘤与慢性幽门螺杆菌胃炎之间的关联。本文将总结目前关于细菌在恶性淋巴瘤,特别是黏膜相关淋巴组织结外边缘区淋巴瘤发生中的致病作用的流行病学、临床和生物学证据。
其他微生物与特定的结外淋巴瘤部位相关,其证据具有变异性且并不总是明确,包括鹦鹉热衣原体、伯氏疏螺旋体、空肠弯曲菌,以及最近的贝纳柯克斯体。根据最合理的模型,淋巴瘤的生长是由慢性感染持续诱导的抗原刺激引起的。然而,也有一些幽门螺杆菌具有直接致癌作用的证据。
淋巴瘤不是单一病因的结果,而是多种因素影响的疾病,受多种遗传和环境因素的影响。因此,确定细菌感染的具体作用并不总是容易的。然而,根除相关的慢性感染可能会导致持续的淋巴瘤消退。此外,感染与淋巴瘤之间的关联为通过预防易患感染或早期治疗来降低淋巴瘤发病率提供了机会。