[Helicobacter pylori eradication for stage I(E₁) gastric mucosa-associated lymphoid tissue lymphoma: predictive factors of complete remission].
OBJECTIVE
Eradication of Helicobacter pylori (H. pylori) is accepted as initial treatment of stage I(E₁) gastric mucosa associated lymphoid tissue (MALT) lymphoma. However, 10-20% of gastric low grade MALT lymphomas are unresponsive to H. pylori eradication treatment. The aim of this study was to find out the predictive factors of complete remission of gastric MALT lymphoma after H. pylori eradication.


METHODS
From 1995 to 2006, consecutive 95 patients with modified Ann Arbor stage I(E₁) gastric MALT lymphoma were enrolled, and their medical records were reviewed. The patients were initially treated by H. pylori eradication. The complete remission was determined by endoscopic and histologic finding.


RESULTS
Eighty eight patients (92.6%) achieved complete remission after H. pylori eradication therapy. Mean follow up time for these patients was 40+/-25 months. Seven patients (7.4%) failed to achieve complete remission. There was no significant difference in the age, sex, endoscopic appearance, and large cell component between the remission group and failure group. Among 66 patients with distal tumor, 65 patients (98.5%) achieved complete remission. On the other hand, among 13 patient with proximal tumor, 9 patients (69.2%) achieved complete remission (p=0.001). The odds ratio of proximal tumor for H. pylori eradication failure was 28.9 (95% CI=2.9-288.0).


CONCLUSIONS
The proximally location of MALT lymphoma is a risk factor of the H. pylori eradication treatment failure. Therefore, the proximally located gastric MALT lymphoma should be carefully treated and followed.
Kim
Su Jin
SJ
Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Yang
Sun
S
Min
Byung-Hoon
BH
Lee
Jun Haeng
JH
Rhee
Poong-Lyul
PL
Rhee
Jong Chul
JC
Kim
Jae J
JJ
D000328:Adult; D000367:Age Factors; D000368:Aged; D005260:Female; D005773:Gastroscopy; D016481:Helicobacter Infections / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D016480:Helicobacter pylori; D006801:Humans; D018442:Lymphoma, B-Cell, Marginal Zone / Q000150:complications / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D016017:Odds Ratio; D011237:Predictive Value of Tests; D012307:Risk Factors; D012737:Sex Factors; D013274:Stomach Neoplasms / Q000150:complications / Q000473:pathology*