title: Antisecretory medication is associated with decreased Helicobacter pylori detection in gastric marginal zone lymphoma.
abstract: Helicobacter pylori status influences the prognosis and management of gastric extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma), so accurate determination of H pylori status is of clinical importance. The low rate of histologic H pylori positivity among gastric MALT lymphoma cases at our institution prompted investigation for possible causes. A case series of 24 patients as having gastric MALT lymphoma (with no diffuse large B-cell component) in a tertiary care setting between 1997 and 2010 was identified, and clinical records were reviewed. Immunohistochemical staining for H pylori and BCL10 was performed. This study received institutional review board approval (protocol number M13-033). Thirty-nine percent of cases (9/23) were H pylori positive by histology, and 4 additional patients had positive serologic results; overall, 57% of cases (13/23) were positive for H pylori. Treatment with antisecretory medications was associated with a lower likelihood of histologic positivity (13% among treated patients vs 75% among untreated; P = .04). Nuclear localization of BCL10 was seen in 2 cases and was not associated with H pylori status. Antisecretory medications decrease the likelihood of histologic detection of H pylori in gastric MALT lymphoma cases. Incorporation of results of serologic or other testing is needed to ensure correct classification with respect to H pylori status.
authors.affiliation: Department of Pathology and Laboratory Medicine, University of Vermont, Burlington, VT.
authors.forename: Kurt B
authors.initials: KB
authors.lastname: Schaberg
authors.affiliation: Department of Pathology and Laboratory Medicine, University of Vermont, Burlington, VT.
authors.forename: Mark F
authors.initials: MF
authors.lastname: Evans
authors.affiliation: Department of Pathology and Laboratory Medicine, University of Vermont, Burlington, VT.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Wilcox
authors.affiliation: Department of Pathology and Laboratory Medicine, University of Vermont, Burlington, VT. Electronic address: mlewis@uvm.edu.
authors.forename: Michael R
authors.initials: MR
authors.lastname: Lewis
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001402:B-Lymphocytes / Q000382:microbiology / Q000473:pathology; D005260:Female; D005753:Gastric Mucosa / Q000382:microbiology / Q000473:pathology; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006801:Humans; D018442:Lymphoma, B-Cell, Marginal Zone / Q000382:microbiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D054328:Proton Pump Inhibitors / Q000627:therapeutic use*; D013270:Stomach / Q000382:microbiology* / Q000473:pathology; D013274:Stomach Neoplasms / Q000382:microbiology* / Q000473:pathology; D013276:Stomach Ulcer / Q000188:drug therapy* / Q000382:microbiology / Q000473:pathology; D016896:Treatment Outcome
chemical_list: D054328:Proton Pump Inhibitors
keywords: Antisecretory medication; Gastric marginal zone lymphoma; Helicobacter pylori; Mucosa-associated lymphoid tissue