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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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Expression profiling of gastric cancer samples by oligonucleotide microarray analysis reveals low degree of intra-tumor variability

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World Journal of Gastroenterology 2005年第38期11卷 5993-5996页

作者： Karolin Trautmann Christine Steudel Dana Grossmann Daniela Aust Gerhard Ehninger Stephan Miehike christian thiede Medical Department Ⅰ Department of Pathology

AIM： Gene expression profiling provides an unique opportunity to gain insight into the development of different types of gastric cancer. Tumor sample heterogeneity is thought to decrease the sensitivity and tumor specificity of microarray analysis. Thus, microdissection and preamplification of RNA is frequently performed. However, this technique may also induce considerable changes to the expression profile. To assess the effect of gastric tumor heterogeneity on expression profiling results, we measured the variation in gene expression within the same gasbic cancer sample by performing a gene chip analysis with two RNA preparations extracted from the same tumor specimen. METHODS： Tumor samples from six intestinal T2 gastric tumors were dissected under liquid nitrogen and RNA was prepared from two separate tumor fragments. Each extraction was individually processed and hybridized to an Affymetrix U133A gene chip covering approximately 18 000 human gene transcripts. Expression profiles were analyzed using Microarray Suite 5.0 （Affymetrix） and GeneSpring 6.0 （Silicon Genetics）. RESULTS： All gastric cancers showed little variance in expression profiles between different regions of the same tumor sample. In this case, gene chips displayed mean pair wise correlation coefficients of 0.94±0.02 （mean±SD）, compared to values of 0.61±0.1 for different tumor samples. Expression of the variance between the two expression profiles as a percentage of “total change” （Affymetrix） revealed a remarkably low average value of 1.18±0.78 for comparing fragments of the same tumor sample. In contrast, comparison of fragments from different tumors revealed a percentage of 24.4±4.5. CONCLUSION： Our study indicates a low degree of expression profile variability within gastric tumor samples isolated from one patient. These data suggest that tumor tissue heterogeneity is not a dominant source of error for microarray analysis of larger tumor samples, making total RNA extraction an appropria

关键词： Gastric cancer Microarray analysis Tissue heterogeneity

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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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