Spencer J, Wotherspoon A C
Department of Histopathology, St Thomas' Hospital, London.
Cancer Surv. 1997;30:213-31.
The majority of low grade gastric lymphomas arise within acquired organized lymphoid tissue, which has all the features of MALT. This MALT is specifically acquired most commonly in response to infection of the gastric mucosa by H pylori. The lymphocytes within this MALT are therefore programmed to respond to this organism and the neoplastic cells of the lymphoma that may develop within this acquired MALT retain the ability to respond to the immunological proliferative drive associated with the continued presence of the organism. Following the removal of this immunological drive by eradication of the organism in vivo, the lymphoma shows clinical and histological regression. The time required to see this response is unknown and there are some lymphomas that fail to respond to simple Helicobacter eradication. In some cases, there is continued molecular evidence of the presence of the lymphoma clone in low levels and the significance of this remains unknown. These factors are presently under detailed examination, and several clinical trials to assess the response of a large series of low grade gastric MALT lymphomas to anti-Helicobacter therapy and the requirement for additional chemotherapy are at present in progress.
大多数低级别胃淋巴瘤起源于获得性有组织淋巴组织，其具有黏膜相关淋巴组织（MALT）的所有特征。这种MALT最常见是在胃黏膜受到幽门螺杆菌感染后特异性获得的。因此，该MALT内的淋巴细胞被编程为对这种微生物作出反应，而可能在这种获得性MALT内发展的淋巴瘤肿瘤细胞保留了对与该微生物持续存在相关的免疫增殖驱动作出反应的能力。在体内通过根除该微生物消除这种免疫驱动后，淋巴瘤显示出临床和组织学消退。出现这种反应所需的时间尚不清楚，并且有一些淋巴瘤对单纯根除幽门螺杆菌没有反应。在某些情况下，持续存在低水平淋巴瘤克隆的分子证据，其意义尚不清楚。目前正在对这些因素进行详细研究，并且目前正在进行多项临床试验，以评估大量低级别胃MALT淋巴瘤对抗幽门螺杆菌治疗的反应以及对额外化疗的需求。
