Nakamura S, Yao T, Aoyagi K, Iida M, Fujishima M, Tsuneyoshi M
Second Department of Pathology, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Cancer. 1997 Jan 1;79(1):3-11.
Few previous articles have analyzed the relation between infection with Helicobacter pylori (H. pylori) and primary gastric lymphoma in a large number of patients.
Resected and biopsied specimens from 237 patients with primary gastric lymphoma were investigated for H. pylori using hematoxylin and eosin stain, modified Giemsa stain, and immunohistochemistry. These specimens were compared with specimens from 29 patients with chronic active gastritis, 33 with peptic ulcers, and 41 with gastric carcinoma.
H. pylori was detected in 145 of 237 patients (61%) with gastric lymphoma. The frequency of H. pylori positivity was higher in patients with lymphoma restricted to the mucosa and submucosa (76%) than in those with lymphoma invading beyond the submucosa (48%) (P < 0.001), and was also higher in patients with low grade mucosa-associated lymphoid tissue lymphoma (72%) than in those with high grade tumors (55%) (P < 0.05). The frequency of H. pylori positivity in patients with lymphoma was lower than in those with chronic active gastritis (100%) (P < 0.001) or peptic ulcer (91%) (P < 0.05). In patients with lymphoma restricted to the mucosa and the superficial portion of the submucosa, the frequency of H. pylori positivity (90%) was as high as that observed in patients with chronic active gastritis and peptic ulcer. The H. pylori grading score for patients with lymphoma (0.9 +/- 1.0) was lower than for those with chronic active gastritis (1.9 +/- 0.8) (P < 0.001), peptic ulcers (2.2 +/- 1.0) (P < 0.001), or gastric carcinoma (1.2 +/- 1.1) (P < 0.05).
These results suggest that H. pylori is more likely to be associated with early states of primary gastric lymphoma than with advanced states. Thus, H. pylori may disappear during the progression of primary gastric lymphoma.
此前很少有文章在大量患者中分析幽门螺杆菌（H. pylori）感染与原发性胃淋巴瘤之间的关系。
使用苏木精-伊红染色、改良吉姆萨染色和免疫组织化学方法，对237例原发性胃淋巴瘤患者的切除标本和活检标本进行幽门螺杆菌检测。将这些标本与29例慢性活动性胃炎患者、33例消化性溃疡患者和41例胃癌患者的标本进行比较。
237例胃淋巴瘤患者中有145例（61%）检测到幽门螺杆菌。局限于黏膜和黏膜下层的淋巴瘤患者中幽门螺杆菌阳性率（76%）高于侵犯超过黏膜下层的淋巴瘤患者（48%）（P<0.001），低级别黏膜相关淋巴组织淋巴瘤患者中幽门螺杆菌阳性率（72%）也高于高级别肿瘤患者（55%）（P<0.05）。淋巴瘤患者中幽门螺杆菌阳性率低于慢性活动性胃炎患者（100%）（P<0.001）或消化性溃疡患者（91%）（P<0.05）。在局限于黏膜和黏膜下层浅层的淋巴瘤患者中，幽门螺杆菌阳性率（90%）与慢性活动性胃炎和消化性溃疡患者中观察到的阳性率一样高。淋巴瘤患者的幽门螺杆菌分级评分（0.9±1.0）低于慢性活动性胃炎患者（1.9±0.8）（P<0.001）、消化性溃疡患者（2.2±1.0）（P<0.001）或胃癌患者（1.2±1.1）（P<0.05）。
这些结果表明，幽门螺杆菌更可能与原发性胃淋巴瘤的早期阶段相关，而不是晚期阶段。因此，幽门螺杆菌可能在原发性胃淋巴瘤进展过程中消失。
