Endoscopic characteristics of low-grade gastric mucosa-associated lymphoid tissue lymphoma after eradication of Helicobacter pylori.
OBJECTIVE
It was recently reported that low-grade gastric lymphoma of mucosa-associated lymphoid tissue (MALT) was regressed by the eradication of Helicobacter pylori. The aim of this study was to confirm the effect of H. pylori eradication on low-grade gastric MALT lymphoma and to investigate the whitish mucosa that appeared with regression of the lesions.


METHODS
Forty-seven H. pylori-positive patients with low-grade gastric MALT lymphoma were treated by using triple therapy. Biopsy specimens were histologically graded and B cell clonality was examined by using reverse transcription-polymerase chain reaction before and after eradication treatment. The relationship between the appearance of whitish mucosa and the degree of gastric gland loss was evaluated.


RESULTS
Histologic regression was observed 2 months after eradication therapy in 42 of 47 patients. However, B cell monoclonality changed to polyclonality in only 23 patients during the follow-up period. The appearance of whitish mucosa in patients who showed histologic regression became more frequent as the degree of gastric gland loss increased (P< 0.001).


CONCLUSIONS
Most low-grade gastric MALT lymphoma histologically regressed after H. pylori eradication. The appearance of whitish mucosa after histologic regression reflected the degree of gastric gland loss. Whitish mucosa is an endoscopic characteristic and may be an endoscopic marker for regression of low-grade gastric MALT lymphoma.
Urakami
Y
Y
Department of Gastroenterology, Urakami Gastroenterology Clinic, Tokushima, Japan.
Sano
T
T
Begum
S
S
Endo
H
H
Kawamata
H
H
Oki
Y
Y
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000328:Adult; D000368:Aged; D000658:Amoxicillin / Q000008:administration & dosage; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D000897:Anti-Ulcer Agents / Q000008:administration & dosage; D001402:B-Lymphocytes / Q000473:pathology; D001483:Base Sequence; D001706:Biopsy; D002999:Clone Cells; D018076:DNA, Complementary / Q000235:genetics; D004273:DNA, Neoplasm / Q000235:genetics; D003627:Data Interpretation, Statistical; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D005753:Gastric Mucosa / Q000473:pathology*; D005773:Gastroscopy; D016481:Helicobacter Infections / Q000150:complications* / Q000188:drug therapy*; D016480:Helicobacter pylori; D006801:Humans; D064747:Lansoprazole; D018442:Lymphoma, B-Cell, Marginal Zone / Q000209:etiology* / Q000235:genetics / Q000473:pathology*; D008297:Male; D008795:Metronidazole / Q000008:administration & dosage; D008875:Middle Aged; D008969:Molecular Sequence Data; D009853:Omeprazole / Q000008:administration & dosage / Q000031:analogs & derivatives; D010406:Penicillins / Q000008:administration & dosage; D012334:RNA, Neoplasm / Q000235:genetics; D020133:Reverse Transcriptase Polymerase Chain Reaction; D013997:Time Factors
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000900:Anti-Bacterial Agents; D000897:Anti-Ulcer Agents; D018076:DNA, Complementary; D004273:DNA, Neoplasm; D010406:Penicillins; D012334:RNA, Neoplasm; D064747:Lansoprazole; D008795:Metronidazole; D000658:Amoxicillin; D009853:Omeprazole