Regression of gastric MALT lymphoma after eradication of Helicobacter pylori is predicted by endosonographic staging
Regression of gastric MALT lymphoma after eradication of Helicobacter pylori is predicted by endosonographic staging
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DOI：
10.1053/gast.1997.v113.pm9322502
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发表时间：
1997-10-01
期刊：
影响因子：
29.4
通讯作者：
Zellman, A
中科院分区：
文献类型：
--
作者：
Sackmann, M;Morgner, A;Zellman, A
背景与目的：最近的研究表明，根除幽门螺杆菌可能导致胃黏膜相关淋巴组织（MALT）的低级别淋巴瘤完全消退，但患者是否从这种治疗中受益尚不清楚。本研究的目的是前瞻性研究超声内镜分期是否预测根除幽门螺杆菌治疗MALT淋巴瘤的结果。方法：22例胃b细胞MALT淋巴瘤幽门螺旋杆菌阳性患者在诊断时经超声内镜检查，治疗幽门螺旋杆菌为口服奥美拉唑和阿莫西林2周。对患者进行内镜检查和活检。结果：所有患者幽门螺杆菌均被根除，随访中MALT淋巴瘤完全消退12例（54%），部分消退5例（23%），无应答5例（23%），14例局限于粘膜或粘膜下层（E-I-1期）的淋巴瘤患者中12例（超声内镜检查），10例高分期患者均未见MALT淋巴瘤完全消退（P < 0.01）。在E-I-1期患者中，6个月时淋巴瘤完全消退的概率为60%，12个月时为79%，14个月时为100%。结论：超声内镜对胃低级别MALT淋巴瘤的分期可以预测根除幽门螺杆菌治疗的反应。
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 I 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-I-1) at echoendoscopy, but none of the 10 patients with higher stage (P < 0.01), showed complete regression of MALT lymphoma. In stage E-I-1 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.