Korean J Helicobacter Up Gastrointest Res.  2019 Jun;19(2):115-119. 10.7704/kjhugr.2019.19.2.115.

Lower Risk of Gastric Atrophy and Intestinal Metaplasia in Patients with MALT Lymphoma despite Helicobacter pylori Infection

Affiliations
  • 1Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea. adagio@catholic.ac.kr

Abstract

BACKGROUND/AIMS
Atrophic gastritis and intestinal metaplasia are sequential consequences of chronic Helicobacter pylori (H. pylori) infection. These conditions are well known to increase the risk of gastric adenocarcinoma development. Gastric mucosa-associated lymphoid tissue (MALT) lymphoma is also a malignant consequence of H. pylori infection, but the relationship between gastric MALT lymphoma and atrophic gastritis-intestinal metaplasia has not been a focus of interest. We investigated the clinical characteristics of atrophic gastritis and intestinal metaplasia in patients with gastric MALT lymphoma.
MATERIALS AND METHODS
A study was conducted by reviewing the electronic medical records of patients diagnosed as having gastric MALT lymphoma at an academic institute, the Yeouido St. Mary's Hospital, Seoul, Korea, between January 2001 and December 2018.
RESULTS
Fifty-eight subjects were enrolled consecutively during the study period and analyzed retrospectively. The patients' mean age was 56.9 years old. The male-to-female ratio was 1.15 (31/27). On histological examination, background atrophic gastritis and intestinal metaplasia were detected in 26.8% (15/58) of cases. Serum pepsinogen I, II and gastrin levels, as serological markers of atrophy, were evaluated in 28 subjects. Three (5.2%) of the 28 cases were compatible with serological atrophic gastritis (pepsinogen I/II ratio of <3 and pepsinogen I level of <70 ng/mL).
CONCLUSIONS
In patients with gastric MALT lymphoma, the prevalence of background mucosal atrophy or intestinal metaplasia was 26.8% on histological examination and 5.2% on serological analyses. These rates are lower than those in patients with gastric adenocarcinoma. This result suggests a different carcinogenic pathway of gastric MALT lymphoma from that of adenocarcinoma.

Keyword

Gastritis, atrophic; Helicobacter pylori; Intestinal metaplasia; Lymphoma; Stomach

MeSH Terms

Adenocarcinoma
Atrophy*
Electronic Health Records
Gastrins
Gastritis, Atrophic
Helicobacter pylori*
Helicobacter*
Humans
Korea
Lymphoid Tissue
Lymphoma
Lymphoma, B-Cell, Marginal Zone*
Metaplasia*
Pepsinogen A
Prevalence
Retrospective Studies
Seoul
Stomach
Gastrins
Pepsinogen A
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