Sorrentino D, Ferraccioli G F, DeVita S, Avellini C, Beltrami C A, Labombarda A, Bernardis V, De Biase F, Trevisi A, Pivetta B, Boiocchi M, Bartoli E
Department of Internal Medicine, University of Udine, Italy.
Gut. 1996 Jun;38(6):837-40. doi: 10.1136/gut.38.6.837.
Although Helicobacter pylori has been implicated in the pathogenesis of gastric mucosa associated lymphoid tissue (MALT) and MALT lymphoma, it is not known how it may trigger these lesions and whether there is an identifiable pre-neoplastic stage.
To investigate the relation between MALT, H pylori infection, and B-cell clonality (a potential marker of pre-neoplastic lesions).
141 subjects with simple dyspepsia.
Gastric biopsy specimens from all patients were examined for MALT and H pylori. Of these, 25 consecutive MALT positive specimens were scored for features of MALT lymphoma and VDJ clonality studied by polymerase chain reaction.
Overall, prevalence was 62% for H pylori and 46% for MALT. VDJ clonality was frequent in the sub-group studied (nine of 25), mostly associated with lymphoid follicles (eight of nine or 89%), and with a high scoring for MALT lymphoma. VDJ clonality was equally frequent in patients with and without H pylori (seven of 20 and two of five or 35% and 40% respectively).
B-cell clonality is unexpectedly common in subjects with simple dyspepsia and MALT raising clinical management questions. These findings also suggest that the cascade MALT formation--B-cell clonality--MALT lymphoma may not be uniquely associated with H pylori infection.
尽管幽门螺杆菌与胃黏膜相关淋巴组织（MALT）及MALT淋巴瘤的发病机制有关，但其如何引发这些病变以及是否存在可识别的肿瘤前阶段尚不清楚。
研究MALT、幽门螺杆菌感染与B细胞克隆性（肿瘤前病变的潜在标志物）之间的关系。
141例单纯消化不良患者。
对所有患者的胃活检标本进行MALT和幽门螺杆菌检查。其中，连续25份MALT阳性标本根据MALT淋巴瘤特征进行评分，并通过聚合酶链反应研究VDJ克隆性。
总体而言，幽门螺杆菌感染率为62%，MALT发生率为46%。在研究的亚组中VDJ克隆性很常见（25例中有9例），大多与淋巴滤泡有关（9例中有8例，即89%），且MALT淋巴瘤评分较高。有和没有幽门螺杆菌感染的患者中VDJ克隆性同样常见（分别为20例中的7例和5例中的2例，即35%和40%）。
B细胞克隆性在单纯消化不良和MALT患者中意外地常见，这引发了临床管理问题。这些发现还表明，MALT形成-B细胞克隆性-MALT淋巴瘤这一连续过程可能并非仅与幽门螺杆菌感染有关。
