Gastric mucosa‐associated lymphoid tissue lymphoma and Helicobacter pylori infection

OBJECTIVE:  Numerous studies have demonstrated the role of Helicobacter pylori infection in the pathogenesis of gastric MALT lymphoma and the present study aimed to analyze this correlation in Chinese patients. METHODS:  Thirty-five cases of primary gastrointestinal non-Hodgkin's lymphoma that had been surgically resected and pathologically examined during the past 20 years were collected. The tissue samples were re-examined by a physician from the pathology department. Immunohistochemical staining and H. pylori tests were conducted. The clinical diagnosis of gastric MALT lymphoma and the results of therapy were analyzed. RESULTS:  According to the immunohistochemistry results, 21 cases were MALT lymphoma, and of these 16 were gastric MALT lymphoma, one was intestinal MALT lymphoma and four were colonic MALT lymphoma. Of the 16 samples of gastric MALT lymphoma, 13 were positive for H. pylori infection and three could not be evaluated because the sample was full of cancer cells. Of the cases of gastric MALT lymphoma, two were stage I1, five were stage II1, and nine were stage IIE. Eleven patients underwent endoscopy: three were misinterpreted as gastric carcinoma, one was diagnosed as Menetrier's disease, one as chronic atrophic gastritis, and only six cases were correctly diagnosed before surgery. Eradication of H. pylori in one patient with gastric MALT lymphoma resulted in regression of the lesion; that patient was followed up for 3 years without relapse. Fifteen cases underwent surgery and 10 were followed up for 5 years: four relapsed within 1−2 years after operation and six remained well. CONCLUSION:  There is a close relationship between H. pylori infection and gastric MALT lymphoma. Early gastric MALT lymphoma can be cured after eradication of H. pylori. The depth of the lesion should be diagnosed by echoendoscopy and therapy should be chosen on the basis of the stage of the disease.