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Helicobacter pylori
Predictive factors for regression of gastric MALT lymphoma after anti-Helicobacter pyloritreatment
  1. A Ruskoné-Fourmestrauxa,
  2. A Lavergnec,
  3. P H Aegertere,
  4. F Megraudg,
  5. L Palazzoa,
  6. A de Mascarelf,
  7. T Molinad,
  8. J-C L Rambaudb,
  9. the Groupe d'Étude des Lymphomes Digestifs (GELD† ,h
  1. aDepartment of Gastroenterology, Hôtel-Dieu, AP-HP, Paris, France, bHôpital Lariboisière, Paris, France, cDepartment of Pathology, Hôpital Lariboisière, AP-HP, Paris, France, dHôtel Dieu, AP-HP, Paris, France, eDepartment of Biostatistics, Hôpital Ambroise Paré, Boulogne, France, fDepartment of Pathology, University of Bordeaux, France, gDepartment of Bacteriology, University of Bordeaux, France, hFondation Française de Cancérologie Digestive, Dijon, France
  1. Dr A Ruskoné- Fourmestraux, Service de Gastro-entérologie, Hôtel-Dieu, 1 place du Parvis Notre Dame, 75181 Paris Cedex 04, France.agnes.fourmestraux{at}htd.ap-hop-paris.fr

Abstract

BACKGROUND AND AIMS Discrepant remission rates (41–100%) have been reported for patients with localised low grade gastric mucosa associated lymphoid tissue (MALT) lymphoma after eradication ofHelicobacter pylori. The aim of this study was to explain these discrepancies and to determine the predictive factors of gastric lymphoma regression after anti- H pylori treatment.

PATIENTS AND METHODS Forty six consecutive patients with localised gastric MALT lymphoma (Ann Arbor stages IE and IIE) were prospectively enrolled. All had gastric endoscopic ultrasonography and H pyloristatus assessment (histology, culture, polymerase chain reaction, and serology). After anti-H pylori treatment, patients were re-examined every four months.

RESULTS Histological regression of the lymphoma was complete in 19/44 patients (43%) (two lost to follow up). Median follow up time for these 19 responders was 35 months (range 10–47). No regression was noted in the 10H pylori negative patients. Among the 34H pylori positive patients, theH pylori eradication rate was 100%; complete regression rate of the lymphoma increased from 56% (19/34) to 79% (19/24) when there was no nodal involvement at endoscopic ultrasonography. There was a significant difference between the response of the lymphoma restricted to the mucosa and other more deep seated lesions (p<0.006). However, using multivariate analysis, the only predictive factor of regression was the absence of nodal involvement (p<0.0001).

CONCLUSION InH pylori positive patients with localised gastric MALT lymphoma, carefully evaluated and treated without any lymph node involvement assessed by endoscopic ultrasonography, complete remission of lymphoma was reached in 79% of cases.

  • mucosa associated lymphoid tissue
  • gastric lymphoma
  • Helicobacter pylori

  • Abbreviations used in this paper

    MALT
    mucosa associated lymphoid tissue
    GL
    gastric lymphoma
    EUS
    endoscopic ultrasonography
    CT
    computed tomography
    PCR
    polymerase chain reaction

    • https://doi.org/10.1136/gut.48.3.297

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    • Abbreviations used in this paper

      MALT
      mucosa associated lymphoid tissue
      GL
      gastric lymphoma
      EUS
      endoscopic ultrasonography
      CT
      computed tomography
      PCR
      polymerase chain reaction
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