胃黏膜相关淋巴组织淋巴瘤在根除幽门螺杆菌后的消退可通过内镜超声分期预测。黏膜相关淋巴组织淋巴瘤研究组。

Regression of gastric MALT lymphoma after eradication of Helicobacter pylori is predicted by endosonographic staging. MALT Lymphoma Study Group.

作者信息

Sackmann M, Morgner A, Rudolph B, Neubauer A, Thiede C, Schulz H, Kraemer W, Boersch G, Rohde P, Seifert E, Stolte M, Bayerdoerffer E

机构信息

Department of Medicine II, University of Munich, Germany.

出版信息

Gastroenterology. 1997 Oct;113(4):1087-90. doi: 10.1053/gast.1997.v113.pm9322502.

DOI:10.1053/gast.1997.v113.pm9322502

PMID:9322502

Abstract

BACKGROUND & AIMS: Recent studies suggest that eradication of Helicobacter pylori may result in complete regression of low-grade lymphoma of the gastric mucosa-associated lymphoid tissue (MALT). Which patients benefit from this treatment is unknown. The aim of this study was to prospectively study whether staging by echoendoscopy predicts the outcome of treatment of MALT lymphoma by eradication of H. pylori.

METHODS

Twenty-two patients positive for H. pylori with low-grade gastric B-cell MALT lymphoma were examined by echoendoscopy at the time of diagnosis. Treatment for H. pylori consisted of a 2-week course of oral omeprazole and amoxicillin. Patients were followed up by endoscopy and biopsy.

RESULTS

H. pylori was eradicated in all patients. Complete regression of MALT lymphoma was observed in 12 patients (54%), partial regression in 5 patients (23%), and no response in 5 patients (23%) during follow-up. Twelve of 14 patients with lymphoma restricted to the mucosa or submucosa (stage E-I1) at echoendoscopy, but none of the 10 patients with higher stage (P < 0.01), showed complete regression of MALT lymphoma. In stage E-I1 patients, the probability of complete regression of lymphoma was 60% at 6, 79% at 12, and reached 100% at 14 months, respectively.

CONCLUSIONS

Staging of gastric low-grade MALT lymphomas by endoscopic ultrasonography allows prediction of the response to therapy by eradication of H. pylori.

摘要

背景与目的

近期研究表明，根除幽门螺杆菌可能会使胃黏膜相关淋巴组织（MALT）低度淋巴瘤完全消退。尚不清楚哪些患者能从这种治疗中获益。本研究的目的是前瞻性地研究超声内镜分期是否能预测通过根除幽门螺杆菌治疗MALT淋巴瘤的效果。

方法

22例幽门螺杆菌阳性的胃低度B细胞MALT淋巴瘤患者在诊断时接受了超声内镜检查。幽门螺杆菌的治疗采用口服奥美拉唑和阿莫西林2周疗程。患者通过内镜检查和活检进行随访。

结果

所有患者的幽门螺杆菌均被根除。随访期间，12例患者（54%）的MALT淋巴瘤完全消退，5例患者（23%）部分消退，5例患者（23%）无反应。超声内镜检查显示，14例淋巴瘤局限于黏膜或黏膜下层（E-I1期）的患者中有12例MALT淋巴瘤完全消退，但10例更高分期的患者中无一例完全消退（P<0.01）。在E-I1期患者中，淋巴瘤完全消退的概率在6个月时为60%，12个月时为79%，14个月时达到100%。