Treatment of gastric MALT lymphoma by Helicobacter pylori eradication: a study controlled by endoscopic ultrasonography.
OBJECTIVE
Previous studies have demonstrated a link between Helicobacter pylori infection and low grade B-cell gastric MALT lymphoma. The aim of this study was to evaluate the effect of Helicobacter pylori eradication in 17 patients with low grade B-cell gastric MALT lymphoma stage EI.


METHODS
For disease staging EUS and CT scan were systematically performed. Eight patients were excluded from the present series because stage EII disease was diagnosed. To demonstrate B-cell monoclonality, immunohistochemistry and polymerase chain reaction were used. H. pylori eradication was performed with triple therapy.


RESULTS
H. pylori was eradicated in all patients after first (n = 15) or second line (n = 2) treatment. Histologic regression of lymphoma was observed in all patients after a median period of 2 mo. Disappearance of monoclonality according to polymerase chain reaction took significantly longer (7 mo). At the end of the study, four of 16 patients still exhibited persistent monoclonal bands. Relapse of lymphoma occurred in two patients associated with H. pylori reinfection/recrudescence.


CONCLUSIONS
Eradication of H. pylori seems to be an effective therapy in patients with stage EI gastric MALT lymphoma, although long-term results are still uncertain. Endoscopic ultrasonography is useful for a more accurate staging of the disease. The clinical significance of detecting monoclonality by polymerase chain reaction remains to be determined.
Nobre-Leitão
C
C
Serviço de Gastrenterologia, Centro de Investigação em Patobiologia Molecular, Departamento de Patologia Morfológica, Instituto Português de Oncologia Francisco Gentil, Lisboa.
Lage
P
P
Cravo
M
M
Cabeçadas
J
J
Chaves
P
P
Alberto-Santos
A
A
Correia
J
J
Soares
J
J
Costa-Mira
F
F
D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D019160:Endosonography; D005260:Female; D016481:Helicobacter Infections / Q000150:complications / Q000188:drug therapy*; D016480:Helicobacter pylori; D006801:Humans; D018442:Lymphoma, B-Cell, Marginal Zone / Q000000981:diagnostic imaging / Q000382:microbiology* / Q000473:pathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009853:Omeprazole / Q000627:therapeutic use; D011446:Prospective Studies; D012008:Recurrence; D013272:Stomach Diseases / Q000188:drug therapy; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging / Q000382:microbiology* / Q000473:pathology / Q000628:therapy
D000900:Anti-Bacterial Agents; D000897:Anti-Ulcer Agents; D009853:Omeprazole