Long term outcome of patients with gastric marginal zone B cell lymphoma of mucosa associated lymphoid tissue (MALT) following exclusive Helicobacter pylori eradication therapy:: experience from a large prospective series
Long term outcome of patients with gastric marginal zone B cell lymphoma of mucosa associated lymphoid tissue (MALT) following exclusive Helicobacter pylori eradication therapy:: experience from a large prospective series
复制标题
DOI：
10.1136/gut.53.1.34
复制
发表时间：
2004-01-01
期刊：
影响因子：
24.5
通讯作者：
Stolte, M
中科院分区：
文献类型：
--
作者：
Fischbach, W;Goebeler-Kolve, ME;Stolte, M
背景资料：幽门螺杆菌在胃黏膜相关淋巴组织（MALT）边缘区B细胞淋巴瘤的发病机制中起决定性作用，根除治疗已成为广泛接受的I期疾病的初始治疗方法。目的：确定接受单纯幽门螺杆菌根除治疗的患者的长期结局。设计：一系列新诊断的MALT边缘区B细胞淋巴瘤患者的前瞻性研究。背景：在德国和奥地利进行的多中心研究。患者：95名患者;其中90名（5名失访）平均年龄为54.3（27 - 85）岁，随访至少12个月。干预：完成分期工作，揭示I期疾病和幽门螺杆菌感染。患者接受三联疗法（OMC：奥美拉唑20 mg，每日2次，甲硝唑400 mg，每日2次，克拉霉素250 mg，每日2次; OAC：奥美拉唑20 mg，每日2次，阿莫西林1000 mg，每日2次，克拉霉素500 mg）治疗1 wk。88例患者（98%）成功根除幽门螺杆菌; 2例患者根除治疗失败。长期结果的特征为56例患者（62%）淋巴瘤完全消退，17例患者（18%）微小残留病变，11例患者（12%）部分缓解，4例患者（4%）无变化，2例患者（2%）疾病进展。4例完全缓解患者在6、8、8和15个月后复发，1例显示幽门螺杆菌再感染。与内窥镜超声诊断的I2期相比，I1期疾病的消退率较高。结论：大多数接受单纯幽门螺杆菌根除治疗的低度胃MALT淋巴瘤患者具有良好的长期结局，提供了真实的治愈机会。
Background: Helicobacter pylori plays a decisive role in the pathogenesis of gastric marginal zone B cell lymphoma of mucosa associated lymphoid tissue ( MALT), and eradication therapy has become a widely accepted initial treatment of stage I disease.Objective: To determine the long term outcome of patients undergoing exclusive H pylori eradication therapy.Design: A prospective series of patients with newly diagnosed marginal zone B cell lymphoma of MALT.Setting: Multicentre study in Germany and Austria.Patients: Ninety five patients; 90 of these ( five lost to follow up) with a mean age of 54.3 ( 27 - 85) years were followed up for at least 12 months.Intervention: Complete staging work up revealing stage I disease and H pylori infection. Patients received triple therapy ( OMC: omeprazole 20 mg twice daily, metronidazole 400 mg twice daily, and clarithromycin 250 mg twice daily; or OAC: omeprazole 20 mg twice daily, amoxycillin 1000 mg twice daily, and clarithromycin 500 twice daily) for one week.Results: Median follow up was 44.6 ( 12 - 89) months. H pylori was successfully eradicated in 88 patients ( 98%); in two patients eradication therapy failed. Long term outcome was characterised by complete regression of lymphoma in 56 patients ( 62%), minimal residual disease in 17 patients ( 18%), partial remission in 11 patients ( 12%), no change in four patients ( 4%), and progressive disease in two patients ( 2%). Four patients with complete remission relapsed after 6, 8, 8, and 15 months, one revealing reinfection by H pylori. Regression rate was higher in stage I1 disease compared with stage I2, as diagnosed by endoscopic ultrasound.Conclusion: The majority of patients with low grade gastric MALT lymphoma treated by exclusive H pylori eradication have a favourable long term outcome, offering a real chance of cure.