Gastric MALT lymphoma and its relationship to Helicobacter pylori infection

TY - JOUR

T1 - Gastric MALT lymphoma and its relationship to Helicobacter pylori infection

T2 - management and pathogenesis of the disease

AU - Morgner, A

AU - Bayerdörffer, E

AU - Neubauer, A

AU - Stolte, M

N1 - Copyright 2000 Wiley-Liss, Inc.

PY - 2000/3/15

Y1 - 2000/3/15

N2 - Chronic Helicobacter pylori infection is strongly associated with the development of primary gastric B cell lymphoma of MALT-type. Therapeutic decisions in primary gastric MALT lymphomas, e.g., the choice for gastric surgery or stomach-conserving treatments in the form of radio-, chemo-, or eradication therapy, should be based on an accurate histopathological diagnosis, grading and clinical staging. Primary gastric low-grade MALT-NHLs in an early clinical stage associated with H. pylori infection were shown to respond with complete remission in approximately 77% of cases upon successful cure of the infection as only treatment modality. The effect of curing H. pylori infection on the course of a high-grade gastric MALT lymphoma is largely uncertain but preliminary results indicate a possible benefit for patients with high-grade MALT lymphoma upon eradication therapy. Concerning the pathogenetic mechanisms of lymphomagenesis, there are many questions to be addressed in the near future. In general, it is still unclear what the exact mechanisms are which lead to the malignant transformation of a reactive infiltrate. Is there a molecular-genetic or immunological point of no return? What is the biological significance of the immunoglobulin rearrangement detected with PCR? The wave of new data each year about the role of H. pylori in gastric MALT lymphoma might help that many of these questions addressed above might be answered within the next years.

AB - Chronic Helicobacter pylori infection is strongly associated with the development of primary gastric B cell lymphoma of MALT-type. Therapeutic decisions in primary gastric MALT lymphomas, e.g., the choice for gastric surgery or stomach-conserving treatments in the form of radio-, chemo-, or eradication therapy, should be based on an accurate histopathological diagnosis, grading and clinical staging. Primary gastric low-grade MALT-NHLs in an early clinical stage associated with H. pylori infection were shown to respond with complete remission in approximately 77% of cases upon successful cure of the infection as only treatment modality. The effect of curing H. pylori infection on the course of a high-grade gastric MALT lymphoma is largely uncertain but preliminary results indicate a possible benefit for patients with high-grade MALT lymphoma upon eradication therapy. Concerning the pathogenetic mechanisms of lymphomagenesis, there are many questions to be addressed in the near future. In general, it is still unclear what the exact mechanisms are which lead to the malignant transformation of a reactive infiltrate. Is there a molecular-genetic or immunological point of no return? What is the biological significance of the immunoglobulin rearrangement detected with PCR? The wave of new data each year about the role of H. pylori in gastric MALT lymphoma might help that many of these questions addressed above might be answered within the next years.

KW - Gastric Mucosa

KW - Helicobacter Infections

KW - Helicobacter pylori

KW - Humans

KW - Lymphoma, B-Cell, Marginal Zone

KW - Lymphoma, Non-Hodgkin

KW - Neoplasm Staging

KW - Stomach Neoplasms

KW - Journal Article

KW - Review

U2 - 10.1002/(SICI)1097-0029(20000315)48:6<349::AID-JEMT5>3.0.CO;2-7

DO - 10.1002/(SICI)1097-0029(20000315)48:6<349::AID-JEMT5>3.0.CO;2-7

M3 - SCORING: Journal article

C2 - 10738316

VL - 48

SP - 349

EP - 356

IS - 6

ER -