根除幽门螺杆菌对胃黏膜相关淋巴组织淋巴瘤疗效分析

Effect of Helicobacter pylori eradication on the treatment of patients with gastric mucosa-associated lymphoid tissue lymphoma

[目的]分析不同分期及幽门螺旋杆菌(Hp)感染状态的胃黏膜相关淋巴组织(MALT)淋巴瘤患者是(否)根除Hp的疗效。[方法]收集43例胃MALT淋巴瘤患者,对其临床资料、内镜表现、病理检查及转归进行回顾性研究。[结果]43例中28例(65.1%)Hp阳性,根除Hp后总完全缓解(CR)率为76.7%(33/43),Ⅰ~Ⅱ_1期Hp阳性病例初始治疗仅抗Hp,CR率90.9%(10/11)。Ⅱ_2期及以上附加抗肿瘤治疗,根除Hp组及未根除Hp组CR率无显著差异,但根除Hp组3年生存率优于未根除Hp组(P<0.05)。Hp阳性组CR率高于阴性组(88.2%∶46.7%,P<0.05)。Hp阴性病例中,根除Hp者的3年生存率优于未根除Hp者(P<0.05)。[结论]根除Hp可使90.9%Ⅰ~Ⅱ_1期患者得到CR,对于Ⅱ_2期及以上Hp阳性患者及Hp阴性患者有延长生存时间的意义,Hp阳性患者预后较好。根除Hp对于各个分期的胃MALT淋巴瘤均有效,无论有无Hp感染。

[Objective]To investigate the effectiveness of Helicobacter pylori （Hp）eradication therapy on gastric mucosa-associated lymphoid tissue（MALT）regardless the lesion stage or the Hp infection sta- tus. [Methods]From May 2009 to December 2016,43 subjects who were diagnosed with gastric MALT lym- phoma were analyzed retrospectively. [Results]Of the 43 patients, Hp infection was detected in 28 patients （65.1%）. The overall complete remission（CR）rate was 76.7 %. The CR rate after eradication therapy was 90.9 % in patients with Hp positive and stage I-II1. CR rate after additional treatment for Stage II2 or above did not present significant difference between eradication therapy group and no eradication therapy group. Three-year survival rate in eradication therapy group was better than no eradication group. The CR rate was higher in Hp positive patients than in Hp negative patients（P〈0.05）. For Hp negative patients, 3- year survival rate in eradication therapy group was better than no eradication group（P〈0.05）. [Conclu- sion]Eradication therapy led to CR in 90.9% of patients with stage I-II1 ,it also may prolonged life survival with Stage II2 or above. Hp positive patients have good prognosis. Eradication therapy is effective for gas- tric MALT lymphoma regardless of the Hp infection status and stage.