胃黏膜相关淋巴组织淋巴瘤BCL10核表达与其对幽门螺杆菌根除治疗无反应相关

Association of BCL10 Nuclear Expression and Non-response of Gastric Mucosa-associated Lymphoid Tissue Lymphoma to Helicobacter pylori Eradication

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： Studies have shown eradication of Helicobacter pylori （H. pylori） resulted in complete regression of early gastric mucosa-associated lymphoid tissue （MALT） lymphoma in approximately 75% of cases, and BCL10 nuclear expression and t（11;18）（q21;q21） can predict non-response of gastric MALT lymphoma to H. pylori eradication. Aims： To appraise the efficacy of 1t. pylori eradication in the treatment of early gastric MALT lymphoma patients in our country, and the predictive value of BCL10 nuclear expression and t（11;18）（q21;q21） in the choice of therapeutic regimens. Methods： Nineteen patients with early gastric MALT lymphoma were studied. BCL10 nuclear expression was assessed by immunohistochemistry, and t（11;18）（q21;q21） by interphase fluorescence in situ hybridization. All patients were initially treated by H. pylori eradication therapy and followed up by endoscopy and biopsy pathology. Results： Of the 19 early gastric MALT lymphoma patients, 10 （52.6%） acquired complete regression after eradication of H. pylori. BCL10 nuclear expression was detected in 2 （20.0%） of the 10 patients that achieved complete regression, but in 7 （77.8%） of the 9 patients who showed no response to eradication therapy （P〈0.05）. t（11;18）（q21;q21） was found in 3 patients （50.0%, 3/6） that had no response to eradication therapy, but none in 8 complete regression patients （P〉0.05）. Conclusions： 52.6% of patients with early gastric MALT lymphoma recruited in this study can acquire complete regression after H. pylori eradication. BCL1O nuclear expression is likely to be related to non-response of gastric MALT lymphoma to eradication therapy.