Gastroenterology Unit, 'Riuniti' Hospital, Foggia, Italy.
Gastroenterology and Digestive Endoscopy, 'Generale' Hospital, Perugia, Italy.
Eur J Haematol. 2022 Dec;109(6):643-647. doi: 10.1111/ejh.13871. Epub 2022 Oct 5.
The role of Helicobater pylori eradication in the treatment of high-grade diffuse large B-cell lymphoma (DLBCL) of the stomach is unclear.
We performed a systematic review and meta-analysis of currently available data. DLBCL-remission rate after eradication therapy, post-remission maintenance, and response rate in the case of additional oncological therapy were extracted.
By considering data of seven studies, the DLBCL remission was achieved in 81 (53.3%; 95% CI = 45.3-61.2) out of 152 H. pylori eradicated patients. The regression rate did not differ between pure DLCBL and DLCBL with MALT component, between stage I and stage II disease, and between Caucasians and Asians. Disease regression was maintained in all patients after at a median of 63 months (range: 46-29) follow-up. In those non-responders, DLBLC remission after additional chemo-immunotherapy was achieved in 63 (98.4%; 95% CI = 95.4-100) out of 64 patients.
Data this systematic review suggest considering H. pylori eradication as first-line therapy to treat infected patients with early-stage, high-grade gastric lymphoma.
幽门螺杆菌（H. pylori）根除在治疗胃高级别弥漫性大 B 细胞淋巴瘤（DLBCL）中的作用尚不清楚。
我们对现有数据进行了系统评价和荟萃分析。提取了根除治疗后、缓解后维持治疗以及在追加肿瘤学治疗时的反应率。
考虑到 7 项研究的数据，在 152 例 H. pylori 根除患者中，81 例（53.3%；95%CI=45.3-61.2）达到了 DLBCL 缓解。单纯 DLBCL 和具有 MALT 成分的 DLBCL、I 期和 II 期疾病、白种人和亚洲人之间的缓解率没有差异。在中位数为 63 个月（范围：46-29）的随访中，所有患者的疾病缓解均得到维持。在那些无应答者中，在 64 例患者中，63 例（98.4%；95%CI=95.4-100）在追加化疗免疫治疗后达到 DLBLC 缓解。
本系统评价的数据表明，考虑将 H. pylori 根除作为一线治疗方法，用于治疗早期、高级别胃淋巴瘤的感染患者。
