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背景:经幽门螺杆菌(H.pylori)根除治疗,约75%的早期胃黏膜相关淋巴组织(MALT)淋巴瘤患者可获得完全缓解。肿瘤细胞有BCL10核表达和t(11;18)(q21;q21)可能提示胃MALT淋巴瘤对根除治疗无反应。目的:探讨单纯H.pylori根除治疗对国人早期胃MALT淋巴瘤的疗效,以及肿瘤细胞BCL10核表达和t(11;18)(q21;q21)对治疗方案选择的提示作用。方法:收集19例早期胃MALT淋巴瘤患者,以免疫组化方法检测BCL10核表达,以间期荧光原位杂交方法检测t(11;18)(q21;q21)。所有患者均首选H.pylori根除治疗,并行内镜活检病理随访。结果:本组19例早期胃MALT淋巴瘤患者中10例(52.6%)经单纯H.pylori根除治疗获得完全缓解。10例完全缓解者中2例(20.0%)肿瘤细胞BCL10核表达阳性,9例对根除治疗无反应者中7例(77.8%)阳性,阳性率显著高于完全缓解者(P<0.05)。14例患者行t(11;18)(q21;q21)检测,8例完全缓解者均未检出该易位,6例对根除治疗无反应者中3例(50.0%)检出该易位,两组检出率差异无统计学意义(P>0.05)。结论:单纯H.pylori根除治疗可使本组52.6%的早期胃MALT淋巴瘤患者获得完全缓解。胃MALT淋巴瘤肿瘤细胞BCL10核表达与其对根除治疗无反应相关。
Background: Approximately 75% of patients with early gastric mucosa-associated lymphoid tissue (MALT) lymphoma have achieved complete remission with H. pylori eradication therapy. Tumor cells with BCL10 nuclear expression and t (11; 18) (q21; q21) may suggest that gastric MALT lymphoma does not respond to eradication therapy. Objective: To investigate the curative effect of simple H. pylori eradication therapy on early stage gastric MALT lymphoma in our country, as well as the nuclear expression of BCL10 in tumor cells and t (11; 18) (q21; q21) on the choice of treatment regimen. Methods: Nineteen patients with early gastric MALT lymphoma were enrolled. The nuclear expression of BCL10 was detected by immunohistochemistry. The t (11; 18) (q21; q21) was detected by interphase fluorescence in situ hybridization. H.pylori eradication was the first choice in all patients, and the pathology of endoscopic biopsy was followed up. Results: Ten patients (52.6%) of 19 patients with early gastric MALT lymphoma achieved complete remission by H.pylori eradication therapy. The expression of BCL10 was positive in 2 cases (20.0%) of 10 complete remission and 7 cases (77.8%) in 9 cases that were nonresponders to eradication therapy, the positive rate was significantly higher than that of complete remission (P <0.05). Forty patients underwent t (11; 18) (q21; q21) testing. No translocation was detected in 8 of the 8 patients with complete remission, and 6 of the 6 patients (50.0%) who did not respond to eradication therapy detected this translocation There was no significant difference in the detection rate between the two groups (P> 0.05). Conclusions: H.pylori eradication alone leads to complete remission in 52.6% of patients with early gastric MALT lymphoma in this group. Nuclear expression of BCL10 in gastric MALT lymphoma tumor cells correlates with no response to eradication therapy.