MALT-type lymphoma of the stomach is associated with Helicobacter pylori strains expressing the CagA protein.
OBJECTIVE
Helicobacter pylori is considered to be involved in the pathogenesis of gastric lymphoma of mucosa-associated lymphoid tissue (MALT) type. Strains expressing the CagA protein (CagA+ strains) have been strongly associated with severe gastritis, duodenal ulceration, and gastric adenocarcinoma. The aim of this study was to determine the presence of H. pylori as well as incidence of CagA+ strains in gastric MALT-type lymphoma.


METHODS
Sera of 68 patients with gastric MALT-type lymphoma (22 with low grade, 36 with high grade, and 10 with secondary high grade) were obtained, and the serological response to CagA was studied by immunoblotting using a purified recombinant CagA protein, a CagA+ strain, and the corresponding isogenic CagA- mutant.


RESULTS
Of the patients with MALT-type lymphoma, 98.5% (67 of 68 patients) were H. pylori seropositive. In the only seronegative patient, the bacterium was detected histologically by Warthin-Starry staining. Of the seropositive patients, 95.5% had serum immunoglobulin G antibodies to CagA compared with 67% of an H. pylori-positive control group (33 of 49 patients; P = 0.000037) with chronic active gastritis.


CONCLUSIONS
These results indicate infection of almost all patients with MALT-type lymphoma by CagA+ H. pylori strains. Strains expressing the CagA protein seem to play a crucial role in the pathogenesis of gastric MALT-type lymphoma.
Eck
M
M
Institut fur Pathologie, Universitat Wurzburg, Germany.
Schmausser
B
B
Haas
R
R
Greiner
A
A
Czub
S
S
Müller-Hermelink
H K
HK
D000328:Adult; D000368:Aged; D000907:Antibodies, Bacterial / Q000032:analysis; D000937:Antigen-Antibody Reactions; D000942:Antigens, Bacterial; D001426:Bacterial Proteins / Q000276:immunology / Q000378:metabolism*; D005260:Female; D005753:Gastric Mucosa / Q000473:pathology*; D016480:Helicobacter pylori / Q000302:isolation & purification / Q000378:metabolism*; D006801:Humans; D008221:Lymphoid Tissue / Q000473:pathology*; D018442:Lymphoma, B-Cell, Marginal Zone / Q000276:immunology / Q000382:microbiology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000276:immunology / Q000382:microbiology / Q000473:pathology*
D000907:Antibodies, Bacterial; D000942:Antigens, Bacterial; D001426:Bacterial Proteins; C080866:cagA protein, Helicobacter pylori