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著者: Angelo Zullo, Cesare Hassan, Francesca Cristofari, Alessandro Andriani, Vincenzo De Francesco, Enzo Ierardi, Silverio Tomao, Manfred Stolte, Sergio Morini, Dino Vaira
雑誌名: Clin Gastroenterol Hepatol. 2010 Feb;8(2):105-10. doi: 10.1016/j.cgh.2009.07.017. Epub 2009 Jul 22.
Abstract/Text
BACKGROUND & AIMS: Different remission rates of gastric low-grade, B-cell, mucosa-associated lymphoid tissue (MALT) lymphoma have been reported after Helicobacter pylori eradication. We assessed the long-term remission and relapse rates of early stage MALT lymphoma in patients treated only by H pylori eradication and identified factors that might predict outcome.
METHODS: This systematic review analyzed data from 32 studies, including 1408 patients.
RESULTS: The MALT lymphoma remission rate was 77.5% (95% confidence interval, 75.3-79.7), and was significantly higher in patients with stage I than stage II(1) lymphoma (78.4% vs 55.6%; P = .0003) and in Asian than in Western groups (84.1% vs 73.8%; P = .0001). Neoplasia confined to the submucosa regressed more frequently than that with deeper invasion (82.2% vs 54.5%; P = .0001); patients with lymphoma localized to the distal stomach experienced regression more frequently than those with lymphoma of the proximal stomach (91.8% vs 75.7%; P = .0037). The remission rate was higher among patients without the API2-MALT1 translocation than in those with this translocation (78% vs 22.2%; P = .0001). In an analysis of data from 994 patients, 7.2% experienced lymphoma relapse during 3253 patient-years of follow-up evaluation, with a yearly recurrence rate of 2.2%. Infection and lymphoma were cured by additional eradication therapy in all patients with H pylori recurrence (16.7%). Five (0.05%) of the patients initially cured of lymphoma developed high-grade lymphoma within 6 to 25 months of therapy.
CONCLUSIONS: H pylori eradication is effective in treating approximately 75% of patients with early stage gastric lymphoma. Long-term follow-up evaluation of these patients is needed to detect early lymphoma relapse or progression.
Copyright 2010 AGA Institute. Published by Elsevier Inc. All rights reserved.
PMID 19631287 Clin Gastroenterol Hepatol. 2010 Feb;8(2):105-10. doi: 10.1016/j.cgh.2009.07.017. Epub 2009 Jul 22.
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