Helicobacter heilmannii-associated primary gastric low-grade MALT lymphoma:: Complete remission after curing the infection
Helicobacter heilmannii-associated primary gastric low-grade MALT lymphoma:: Complete remission after curing the infection
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DOI：
10.1016/s0016-5085(00)70167-3
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发表时间：
2000-05-01
期刊：
影响因子：
29.4
通讯作者：
Bayerdörffer, E
中科院分区：
文献类型：
--
作者：
Morgner, A;Lehn, N;Bayerdörffer, E
背景与目的：幽门螺杆菌感染的治愈可能导致El期相关的低级别粘膜相关淋巴组织淋巴瘤（MALT）完全缓解。本研究探讨海门螺杆菌感染相关的原发性胃MALT淋巴瘤在感染治愈后是否会消退。方法：对连续5例临床分期为El期的原发性胃MALT淋巴瘤患者，采用新的特异性免疫球蛋白G酶联免疫吸附法、16S核糖体RNA扩增和测序，进行组织学诊断海曼螺杆菌诱导的胃炎。患者服用奥美拉唑40 mg和阿莫西林750 mg，每天3次，连用14天。采用聚合酶链反应（PCR）检测治疗前及随访期间免疫球蛋白重链基因重排情况。结果：5例患者（男3例，女2例，平均年龄65岁，年龄范围42 ~ 79岁）。培养、组织学、血清学或PCR均未检出幽门螺杆菌。治疗后，所有病例均治愈，肿瘤在组织学和内镜下均得到完全缓解。5例患者治疗前3例出现单克隆B细胞，其中2例PCR阳性。中位随访期为24个月，未发生淋巴瘤复发或再次感染海氏嗜血杆菌。结论：这些数据表明，赫曼嗜血杆菌感染患者可能出现胃MALT淋巴瘤。这种感染的治愈可能导致MALT淋巴瘤的完全缓解。
Background & Aims: Cure of Helicobacter pylori infection may lead to complete remission of associated low-grade mucosa-associated lymphoid tissue (MALT) lymphoma in stage El. This study investigated whether Helicobacter heilmannii infection-associated primary gastric MALT lymphoma will regress after cure of the infection. Methods: H. heilmannii-induced gastritis was diagnosed histologically, by a new specific immunoglobulin G enzyme-linked immunosorbent assay, and with 16S ribosomal RNA amplification and sequencing in 5 consecutive patients with primary gastric MALT lymphoma clinical stage El. Patients received 40 mg omeprazole and 750 mg amoxicillin 3 times per day for 14 days. Polymerase chain reaction (PCR) was used to detect rearrangement of immunoglobulin heavy-chain genes before treatment and during follow-up. Results: Five patients (3 men, 2 women; mean age, 65 years; range, 42-79 years) were studied. H. pylori was not detected by culture, histology, serology, or PCR. Treatment resulted in the cure of H. heilmannii infection in each case and complete histological and endoscopic remission of the tumors. Three of 5 patients showed monoclonal B cells before treatment, 2 of whom remained PCR positive. Within a median follow-up period of 24 months, no relapse of the lymphoma or reinfection with H. heilmannii occurred. Conclusions: These data suggest that gastric MALT lymphoma may arise in patients with H. heilmannii infection. Cure of this infection may lead to complete remission of the MALT lymphoma.