title: Premalignant gastric lesions in patients with gastric mucosa-associated lymphoid tissue lymphoma and metachronous gastric adenocarcinoma:  a case-control study.
abstract: BACKGROUND
  Patients with gastric mucosa-associated lymphoid tissue lymphoma or diffuse large B-cell lymphoma have an increased risk of developing gastric carcinoma (GC). Identifying patients at high GC risk may lead to improved survival and prognosis. The aim of this case-control study was to evaluate whether premalignant gastric lesions are more prevalent and severe in gastric lymphoma (GL) patients with a subsequent diagnosis of GC than in those without GC.
  
  
  METHODS
  Patients with a first GL diagnosis from 1991-2008 were identified in the Dutch histopathology registry (PALGA). Cases were patients with a diagnosis of GL and a subsequent diagnosis of GC. Controls were patients with a diagnosis of GL without GC development.
  
  
  RESULTS
  In total, eight cases (mean follow-up 5.5 years) and 31 controls (mean follow-up 5.3 years) were included (mean age 60 years). At lymphoma diagnosis, six (75%) cases were diagnosed with premalignant lesions, whereas in the control group, 21 (68%) had histological evidence for premalignant lesions (P=0.69). At GC diagnosis, five (63%) cases showed intestinal metaplasia in the surrounding gastric mucosa. In 22 (71%) controls premalignant lesions were present at the end of follow-up (P=0.47).
  
  
  CONCLUSIONS
  No differences were demonstrated in the prevalence of premalignant lesions of cases and controls at GL diagnosis or the end of follow-up. As the prevalence of premalignant lesions is substantial in both the groups of patients, careful endoscopic surveillance of GL patients is warranted not only for recurrence of lymphoma, but also for progression to adenocarcinoma.
authors.affiliation: Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands. L.Capelle@erasmusmc.nl
authors.forename: Lisette G
authors.initials: LG
authors.lastname: Capelle
authors.forename: Caroline M
authors.initials: CM
authors.lastname: den Hoed
authors.forename: Annemarie C
authors.initials: AC
authors.lastname: de Vries
authors.forename: Katharina
authors.initials: K
authors.lastname: Biermann
authors.forename: Mariel K
authors.initials: MK
authors.lastname: Casparie
authors.forename: Gerrit A
authors.initials: GA
authors.lastname: Meijer
authors.forename: Ernst J
authors.initials: EJ
authors.lastname: Kuipers
mesh_terms: D000230:Adenocarcinoma / Q000150:complications* / Q000473:pathology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D018450:Disease Progression; D005260:Female; D005757:Gastritis, Atrophic / Q000453:epidemiology / Q000473:pathology; D006801:Humans; D018442:Lymphoma, B-Cell, Marginal Zone / Q000150:complications*; D008297:Male; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000453:epidemiology* / Q000473:pathology; D009426:Netherlands / Q000453:epidemiology; D011230:Precancerous Conditions / Q000453:epidemiology* / Q000473:pathology; D015995:Prevalence; D013274:Stomach Neoplasms / Q000453:epidemiology* / Q000473:pathology; D055815:Young Adult