title: Frequent and rapid progression of atrophy and intestinal metaplasia in gastric mucosa of patients with MALT lymphoma.
abstract: OBJECTIVE
  Association of gastric mucosa-associated lymphoid tissue (MALT) low-grade lymphoma and adenocarcinoma has repeatedly been reported. The aim of this study was to evaluate the frequency and the spreading of atrophy and intestinal metaplasia in gastric mucosa of patients with gastric MALT lymphoma followed after conservative treatment.
  
  
  METHODS
  Forty-five patients (mean age 45 +/- 2.1 yr) with gastric MALT lymphoma, treated by Helicobacter pylori eradication, chemotherapy with per os single alkylating agents, or both treatments have been followed by gastroscopy with biopsies in antrum and corpus at least once a year. Univariate and multivariate analysis evaluated the association between the appearance of atrophy and intestinal metaplasia in antrum or corpus and different factors related to patients, H. pylori status, lymphoma features, and treatment. In addition, histological aspects of gastric biopsies at the diagnosis period and at the end of follow-up were compared with those of two control groups of age-matched patients with H. pylori gastritis.
  
  
  RESULTS
  At the diagnosis time, only intestinal metaplasia in corpus was more frequent in patients with gastric MALT lymphoma than in patients with nonulcer dyspepsia. Within median follow-up of 54.4 months (range 9-196), the percentage of patients with gastric atrophy and intestinal metaplasia increased significantly and became significantly higher than in age-matched nonulcer dyspepsia patients. Multivariate analysis showed significant association between corpus intestinal metaplasia and corpus atrophy, intestinal metaplasia in antrum, and duration of the follow-up.
  
  
  CONCLUSIONS
  Conservative management of gastric MALT lymphoma including H. pylori eradication is associated with progression of gastric atrophy and intestinal metaplasia with frequent involvement of the corpus which is known to be a precancerous condition. These findings show that long-term endoscopic monitoring should be recommended in such patients.
authors.affiliation: Service d'Hépato-Gastroentérologie, AP-HP Hôpital Henri Mondor, Créteil, France.
authors.forename: Dominique
authors.initials: D
authors.lastname: Lamarque
authors.forename: Michael
authors.initials: M
authors.lastname: Levy
authors.forename: Mane-Therese
authors.initials: MT
authors.lastname: Chaumette
authors.forename: Francoise
authors.initials: F
authors.lastname: Roudot-Thoraval
authors.forename: Maryan
authors.initials: M
authors.lastname: Cavicchi
authors.forename: Jean
authors.initials: J
authors.lastname: Auroux
authors.forename: Anne
authors.initials: A
authors.lastname: Courillon-Mallet
authors.forename: Corinne
authors.initials: C
authors.lastname: Haioun
authors.forename: Jean-Charles
authors.initials: JC
authors.lastname: Delchier
mesh_terms: D001284:Atrophy; D016009:Chi-Square Distribution; D018450:Disease Progression; D005260:Female; D005753:Gastric Mucosa / Q000473:pathology*; D005773:Gastroscopy; D016481:Helicobacter Infections / Q000188:drug therapy / Q000473:pathology; D016480:Helicobacter pylori; D006801:Humans; D018442:Lymphoma, B-Cell, Marginal Zone / Q000473:pathology* / Q000628:therapy; D008297:Male; D008679:Metaplasia; D008875:Middle Aged; D012307:Risk Factors