Clinical and pathological features in T-cell gastric lymphoma associated with human T-cell leukemia virus type 1 (HTLV-1) in comparison with B-cell gastric lymphoma.
OBJECTIVE
We investigated clinical features of T-cell gastric lymphomas associated with human T-cell leukemia virus type 1 (HTLV-1).


METHODS
Ninety patients with gastric lymphoma who underwent gastrectomy were included in this study. They were divided into T-cell and B-cell gastric lymphomas according to the immunohistochemical expression of surface T-cell or B-cell markers. Clinicopathological features and surgical outcome were compared between T-cell and B-cell gastric lymphomas. Correlation between T-cell gastric lymphoma and Epstein-Barr virus, p53, MIB-1, and CD44 variant 6 on lymphoma cells was evaluated in 60 patients by in situ hybridization and immunohistochemical examination. Anti-adult T-cell leukemia antigen was evaluated in 74 patients in the blood serum were evaluated.


RESULTS
Nine of the 90 patients were classified as T-cell gastric lymphoma. Patients with T-cell gastric lymphoma had significantly more nodal involvement and poorer resectability than those with B-cell gastric lymphoma. Positivity of serum anti-adult T-cell leukemia antigen was significantly higher in T-cell lymphoma patients (100%) than in B-cell lymphoma patients (41%). However, there was no significant difference in Epstein-Barr virus positivity and expression of p53, MIB-1, CD44 variant 6 between T-cell and B-cell lymphomas. The five-year-survival rate in patients with T-cell gastric lymphomas was 0% and whereas that in B-cell gastric lymphoma was 45%, there was a significant difference between the two groups (p < 0.01). Two patients with T-cell lymphoma who underwent emergency gastrectomy died in hospital during follow-up.


CONCLUSIONS
The surgical outcome of patients with T-cell lymphoma with anti-adult T-cell leukemia antigen tended to be very poor, despite curative resection. Thus, intensive chemotherapy is recommended for the patients with HTLV-1 associated T-cell gastric lymphoma.
Ishigami
Sumiya
S
First Department of Surgery, Kagoshima University School of Medicine, 8-35-1 Sakuragaoka, Kagoshima 890-8520, Japan. ishiga@med2.kufm.kagoshima-u.ac.jp
Natsugoe
Shoji
S
Tokuda
Koki
K
Nakajo
Akihiro
A
Che
Xiangming
X
Iwashige
Hirohumi
H
Aridome
Kuniaki
K
Hokita
Shuichi
S
Aikou
Takashi
T
D014408:Biomarkers, Tumor / Q000032:analysis; D016009:Chi-Square Distribution; D005260:Female; D005743:Gastrectomy; D004854:Herpesvirus 4, Human / Q000302:isolation & purification; D015368:Human T-lymphotropic virus 1 / Q000302:isolation & purification*; D006801:Humans; D007124:Immunoenzyme Techniques; D017403:In Situ Hybridization; D016393:Lymphoma, B-Cell / Q000276:immunology / Q000473:pathology / Q000601:surgery; D016399:Lymphoma, T-Cell / Q000276:immunology / Q000473:pathology / Q000601:surgery / Q000821:virology*; D008297:Male; D008875:Middle Aged; D011948:Receptors, Antigen, T-Cell / Q000276:immunology; D018709:Statistics, Nonparametric; D013274:Stomach Neoplasms / Q000276:immunology / Q000473:pathology / Q000601:surgery / Q000821:virology*; D015996:Survival Rate
D014408:Biomarkers, Tumor; D011948:Receptors, Antigen, T-Cell