Korean J Gastroenterol.
2001 Apr;37(4):247-253.
Early Histologic Response to Eradication Therapy in Low-Grade Gastric Mucosa-associated Lymphoid Tissue Lymphoma According to Polymerase Chain Reaction-based B-cell Monoclonality
- Affiliations
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- 1Department of Internal Medicine, University of Ulsan College of Medicine, Health Promotion Center, Asan Medical Center, Seoul, Korea.
- 2Department of Pathology, University of Ulsan College of Medicine, Health Promotion Center, Asan Medical Center, Seoul, Korea.
Abstract
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BACKGROUND/AIMS: There has been little description about the clinical significance of B-cell monoclonality in primary low-grade gastric mucosa-associated lymphoid tissue (MALT) lymphoma. We investigated the effects of B-cell monoclonality on early response to Helicobacter pylori (H. pylori) eradication therapy in patients with H. pylori-positive low-grade gastric MALT lymphoma.
METHODS
Twenty-nine patients with H. pylori-positive low-grade gastric MALT lymphoma were consecutively enrolled. We performed diagnostic tests including esophagogastroduodenoscopy (EGD), endoscopic ultrasonography and CT scan for the patients. PCR with PAGE was used to analyse the patterns of immunoglobulin heavy chain gene rearrangement. All 29 patients received H. pylori-eradication therapy. They were then followed up at regular intervals by EGD with biopsy.
RESULTS
Fifty-five percent (16/29) showed a single band in PAGE after PCR, suggesting a monoclonal proliferation of B-cell lineage. Regardless of B-cell monoclonality, there was no difference in histologic regression rates after 3 months of eradication therapy. However, the MALT lymphomas with B-cell monoclonality showed more ulcerous lesions (p<0.01) and deeper infiltration of tumor into gastric wall (p<0.05) than those without B-cell monoclonality.
CONCLUSIONS
These results suggest that PCR-based B-cell monoclonality may not affect early therapeutic response to H. pylori-eradication therapy in gastric MALT lymphoma in spite of the more aggressive histologic morphology.
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