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Therapy of gastric mucosa associated lymphoid tissue lymphoma

World Journal of Gastroenterology 2007年第26期13卷 3554-3566页

作者： andrea morgner Renate Schmelz Christian Thiede Manfred Stolte Stephan Miehlke Medical DepartmentⅠ University HospitalTechnical University DresdenGermany Institute for Pathology Academic Teaching Hospital BayreuthBayreuthGermany

Gastric mucosa associated lymphoid tissue （MALT） lymphoma has recently been incorporated into the World Health Organization （WHO） lymphoma classification, termed as extranodal marginal zone B-cell lymphoma of MALT-type. In about 90% of cases this lymphoma is associated with H pylori infection which has been dearly shown to play a causative role in lymphomagenesis. Although much knowledge has been gained in defining the clinical features, natural history, pathology, and molecular genetics of the disease in the last decade, the optimal treatment approach for gastric MALT lymphomas, especially locally advanced cases, is still evolving. In this review we focus on data for the therapeutic, stage dependent management of gastric MALT lymphoma. Hence, the role of eradication therapy, surgery, chemotherapy and radiotherapy is critically analyzed. Based on these data, we suggest a therapeutic algorithm that might help to better stratify patients for optimal treatment success.

关键词： Gastric lymphoma Mucosa-associatedlymphoid tissue H pylori Eradication Radiation Surgery Chemotherapy Molecular genetics

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Development of early gastric cancer 4 and 5 years after complete remission of Helicobacter pyloriassociated gastric low-grade marginal zone B-cell lymphoma of MALT type

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World Journal of Gastroenterology 2001年第2期7卷 248-253页

作者： andrea morgner Stephan Miehlke Manfred Stolte andreas Neubauer Birgit Alpen Christian Thiede Hermann Klann Franz-Xaver Hierlmeier Christian Ell Gerhard Ehninger Ekkehard Bayerdorffer Medical Department I Technical University HospitalFetscherstr.74Dresden Institute for Pathology Klinikum BayreuthPreuschwitzer Str.101Bayreuth Centre for Internal Medicine UniversityhospitalBaldingerstr.Marburg Private Gastroenterologist Exerzierplatz 12Passau Med.Dept. Krankenhaus KehlheimKehlheim Centre for Internal Medicine HSKLudwig-Erhard-Str.100WiesbadenGermany

AIM: To report 3 of 120 patients on the German MALT lymphoma trial with H. pylori associated gastric MALT lymphoma who developed early gastric cancer 4 and 5 years, after complete lymphoma remission following cure of H. pylori infection. PATIENTS AND RESULTS: Three patients (two men, 74 and 70 years; one women, 77 years) with H. pylori-associated low-grade MALT lymphoma achieved complete lymphoma remission after being cured. Surveillance endoscopies were performed twice a year in accordance to the protocol. Four years after complete lymphoma remission in two patients, and after 5 years in the other, early gastric adenocarcinoma of the mucosa-type, type IIa and type IIc, respectively, was detected, which were completely removed by endoscopic mucosa resection. In one patient, the gastric cancer was diagnosed at the same location as the previous MALT lymphoma, in the other patients it was detected at different sites of the stomach distant from location of the previous MALT lymphoma. The patients were H. pylori negative during the whole follow-up time. CONCLUSION: These findings strengthen the importance of regular Long-term follow-up endoscopies in patients with complete remission of gastric MALT lymphoma after cure of H. pylori infection. Furthermore, gastric adenocarcinoma may develop despite eradication of H. pylori.

关键词： Helicobacter pylori Adenocarcinoma Aged Disease Susceptibility Female Helicobacter Infections Humans Lymphoma, Mucosa-Associated Lymphoid Tissue Male Remission Induction Stomach Neoplasms

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