The value of EUS in predicting the response of gastric mucosa–associated lymphoid tissue lymphoma to Helicobacter pylori eradication

• Published in: Gastrointestinal endoscopy Vol. 65; no. 1; pp. 89 - 96
• Main Authors: El-Zahabi, Lara M.N., MD, Jamali, Faek R., MD, El-Hajj, Ihab I., MD, Naja, Mohammed, Salem, Ziad, MD, Shamseddine, Ali, MD, El Saghir, Nagi S., MD, Zaatari, Ghazi, MD, Geara, Fady, MD, Soweid, Assaad M., MD
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 2007; Elsevier
• Subjects: Aged; Bacterial diseases; Bacterial diseases of the digestive system and abdomen; Biological and medical sciences; Digestive system. Abdomen; Endoscopy; Endosonography; Female; Gastroenterology and Hepatology; Helicobacter Infections - complications; Helicobacter Infections - drug therapy; Helicobacter pylori; Hematologic and hematopoietic diseases; Human bacterial diseases; Humans; Infectious diseases; Investigative techniques, diagnostic techniques (general aspects); Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Lymphoma, B-Cell, Marginal Zone - diagnostic imaging; Lymphoma, B-Cell, Marginal Zone - microbiology; Lymphoma, B-Cell, Marginal Zone - pathology; Male; Medical sciences; Middle Aged; Neoplasm Invasiveness; Prognosis; Retrospective Studies; Stomach Neoplasms - diagnostic imaging; Stomach Neoplasms - microbiology; Stomach Neoplasms - pathology; Sonography; Stomach; Spirillales; Endoscopic route; Mucosa; Endoscopic ultrasonography; Spirillaceae; Malignant hemopathy; Non Hodgkin lymphoma; Eradication; Infection; MALT lymphoma; Helicobacter pylori; Biopsy; Lymphoproliferative syndrome; Echography; Bacteria; Submucosa; Tumor
• ISSN: 0016-5107; 1097-6779
• DOI: 10.1016/j.gie.2006.05.009

Background Gastric mucosa–associated lymphoid tissue (MALT) lymphoma is associated with Helicobacter pylori infection, and regression of the tumor has been described after its eradication. Objective To determine the value of EUS, in addition to other clinical/endoscopic features, in predicting the response of low-grade MALT lymphoma to H pylori eradication. Design A retrospective, single-center study. Setting and Patients Twenty-two patients with primary gastric MALT lymphoma were identified through a retrospective review of charts of patients seen at the American University of Beirut Medical Center. Only 19 patients with histopathologically confirmed gastric MALT lymphoma and H pylori infection who had EUS staging were included in the study. Main Outcome Measurements Regression of the gastric MALT lymphoma as determined by follow-up endoscopy and mucosal biopsies. Results Patients with disease restricted to the gastric mucosa had a significantly higher rate of complete remission after H pylori eradication compared with patients who had disease infiltrating into the gastric submucosa (77.8% vs 12.5%, P value .007). There was no statistical difference in terms of the mean follow-up time to achieve such response ( P value .212). Age, sex, location of the tumor within the stomach, and endoscopic appearance did not correlate with the probability of complete remission of the MALT lymphoma. Limitations The limitations include a retrospective design and a relatively small sample population. Conclusion EUS determination of the invasion depth of gastric MALT lymphoma helps predict a complete response to H pylori eradication.