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  • Predictive value of endoscopic ultrasonography for regression of gastric low grade and high grade MALT lymphomas after eradication ofHelicobacter pylori

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Helicobacter pylori
Predictive value of endoscopic ultrasonography for regression of gastric low grade and high grade MALT lymphomas after eradication ofHelicobacter pylori
  1. S Nakamuraa,
  2. T Matsumotoa,
  3. H Suekaneb,
  4. M Takeshitac,
  5. K Hizawaa,
  6. M Kawasakia,
  7. T Yaod,
  8. M Tsuneyoshid,
  9. M Iidab,
  10. M Fujishimaa
  1. aSecond Department of Internal Medicine, Faculty of Medicine, Kyushu University, Fukuoka, Japan, bDivision of Gastroenterology, Department of Medicine, Kawasaki Medical School, Kurashiki, Japan, cDivision of Pathology, National Kyushu Medical Center, Fukuoka, Japan, dSecond Department of Pathology, Faculty of Medicine, Kyushu University, Fukuoka, Japan
  1. Dr S Nakamura, Second Department of Internal Medicine, Faculty of Medicine, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka 812-8582, Japan. shonaka{at}intmed2.med.kyushu-u.ac.jp

Abstract

BACKGROUND While a close association between gastric mucosa associated lymphoid tissue (MALT) lymphoma and Helicobacter pyloriinfection has been established, there are still cases which do not respond to H pylori eradication.

AIMS To investigate the clinicopathological factors which may help predict the therapeutic efficacy of H pylori eradication in gastric MALT lymphoma.

PATIENTS Forty one patients with gastric MALT lymphoma, including low and high grade lesions.

METHODS After endosonographic staging was determined, H pylori was eradicated in all patients, and the subsequent gastric pathological course was then investigated.

RESULTS Complete regression of MALT lymphoma was observed in 29(71%) patients, partial regression in five (12%), and no regression in seven (17%). Twenty six (93%) of 28 MALT lymphomas restricted to the mucosa but only three (23%) of 13 lymphomas which invaded the deep portion of the submucosa or beyond completely regressed. Kaplan-Meier analysis for the probability of complete regression of MALT lymphoma revealed a significant difference between tumours restricted to the mucosa and those invading the submucosa deeply or beyond (p<0.05). Neither the presence of a high grade component, perigastric lymphadenopathy, nor clinical staging prior to eradication correlated with the probability of lymphoma regression.

CONCLUSIONS Assessment of deep submucosal invasion by endosonography is valuable for predicting the efficacy of H pylorieradication in gastric MALT lymphoma.

  • gastric lymphoma
  • mucosa associated lymphoid tissue
  • Helicobacter pylori
  • endoscopic ultrasonography

  • Abbreviations used in this paper

    MALT
    mucosa associated lymphoid tissue
    EUS
    endoscopic ultrasonography
    RLH
    reactive lymphoid hyperplasia

    • https://doi.org/10.1136/gut.48.4.454

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    • Abbreviations used in this paper

      MALT
      mucosa associated lymphoid tissue
      EUS
      endoscopic ultrasonography
      RLH
      reactive lymphoid hyperplasia
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