Korean J Gastroenterol.  2010 Feb;55(2):94-99. 10.4166/kjg.2010.55.2.94.

Helicobacter pylori Eradication for Stage IE1 Gastric Mucosa-associated Lymphoid Tissue Lymphoma: Predictive Factors of Complete Remission

• Kim SJ
• Yang S
• Min BH
• Lee JH
• Rhee PL
• Rhee JC
• Kim JJ

• KMID: 1718292
• DOI: http://doi.org/10.4166/kjg.2010.55.2.94

Abstract

BACKGROUND/AIMS
Eradication of Helicobacter pylori (H. pylori) is accepted as initial treatment of stage IE1 gastric mucosa associated lymphoid tissue (MALT) lymphoma. However, 10-20% of gastric low grade MALT lymphomas are unresponsive to H. pylori eradication treatment. The aim of this study was to find out the predictive factors of complete remission of gastric MALT lymphoma after H. pylori eradication.
METHODS
From 1995 to 2006, consecutive 95 patients with modified Ann Arbor stage I(E1) gastric MALT lymphoma were enrolled, and their medical records were reviewed. The patients were initially treated by H. pylori eradication. The complete remission was determined by endoscopic and histologic finding.
RESULTS
Eighty eight patients (92.6%) achieved complete remission after H. pylori eradication therapy. Mean follow up time for these patients was 40+/-25 months. Seven patients (7.4%) failed to achieve complete remission. There was no significant difference in the age, sex, endoscopic appearance, and large cell component between the remission group and failure group. Among 66 patients with distal tumor, 65 patients (98.5%) achieved complete remission. On the other hand, among 13 patient with proximal tumor, 9 patients (69.2%) achieved complete remission (p=0.001). The odds ratio of proximal tumor for H. pylori eradication failure was 28.9 (95% CI=2.9-288.0).
CONCLUSIONS
The proximally location of MALT lymphoma is a risk factor of the H. pylori eradication treatment failure. Therefore, the proximally located gastric MALT lymphoma should be carefully treated and followed.

Keyword

MALT lymphoma; H. pylori; Location; Therapy

MeSH Terms

Adult
Age Factors
Aged
Female
Gastroscopy
Helicobacter Infections/complications/*drug therapy/pathology
*Helicobacter pylori
Humans
Lymphoma, B-Cell, Marginal Zone/complications/*pathology
Male
Middle Aged
Neoplasm Staging
Odds Ratio
Predictive Value of Tests
Risk Factors
Sex Factors
Stomach Neoplasms/complications/*pathology

Figure

• 

  Fig. 1. Different treatment response to H. pylori eradication according to site. (A, B) A case of gastric MALT lymphoma located on the distal part of stomach showing complete response 3 months after H. pylori eradication (A: before treatment, B: after treatment). (C, D) A case of gastric MALT lymphoma located on the proximal part of stomach showing no improvement during follow-up of 9 months after H. pylori eradication (C: before treatment, D: after treatment).

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