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J Gastroenterol Dig Dis 2017 | Volume 2, Issue 3
World Gastroenterological &
Gastroenterology and Endoscopy
October 30-31, 2017 | Toronto, Canada
World Congress on
The clinical outcomes and the pathogenic background of gastric MALT lymphoma in Korea
Sang Min Lee, Dae Young Cheung
and
Seung Won Ahn
Catholic University of Korea College of Medicine, Korea
Background/Aims:
Gastric MALT lymphoma is well known
slowly progressing malignancy and has a pathogenic
trigger, Helicobacter pylori infection, commonly with
gastric adenocarcinoma. Literatures report about 6 times
higher incidence of adenocarcinoma in gastric MALT
lymphoma patients compared to that of general population.
However, the development of gastric MALT lymphoma and
adenocarcinoma seems to have different pathways. In this
study, authors investigated the clinical course of gastric
MALT lymphoma and the pathogenic background in the view
point of Correa’s hypothesis.
Materials & Methods:
Study was conducted by review of
electronic medical record of patients who were diagnosed
with gastric MALT lymphoma at an academic institute, the
Yeouido St. Mary’s Hospital, Seoul, Korea, from January 2001
to May 2017. Clinical course was evaluated with analysis
of demographic features, treatment modality and clinical
outcomes. pathogenetic background was investigated in by
Helicobacter pylori infection status, histology and serology.
Results:
A total of 46 subjects were enrolled and analyzed
during the study period. The mean age was 57.19-year-old
(range 36 ~ 85). The male to female ratio was 1.19 (25/21).
Endoscopic appearances varied; thirteen subjects presented
ulcerative mass (28.26%), 12 (26.09%) as flat atrophic patch
of discoloration, 16 (34.78%) erosive patches, 2 (4.35%)
multiple polypoid lesion and 3 (6.52%) subepithelial tumor
like. Helicobacter pylori infection was proved in 82.6 % (38 /
46). Atrophy and intestinal metaplasia were accompanied in
background mucosa in 28.26% (13/46). Serum pepsinogen
I and II, as serological marker for atrophy, was evaluated
in 17 subjects. Only 9 of 17 (52.94%) showed compatible
with gastric atrophy (pepsinogen I / II ratio of less than 3
or pepsinogen I of less than 70). The lymphoma stage by
Lugano stage was I1E (80.43%), I2E (2.17%), II1E (15.22%)
and IIIE (2.17%). genetic alternation, t(11:18), was proved
in 4 of 15 patients (23.53%). The treatment of gastric
MALT lymphoma varied. 32 patients were treated with
Helicobacter eradication therapy. Four patients received
chemotherapy
with
cyclophosphamide,
adriamycin,
vincristine, prednisolone (CHOP) regimen, five patients
received Radiotherapy and three patients underwent
surgery. Of the 46 patients with MALT lymphoma, except
for two who was referred to another hospital, 44 patients
(100%) had complete remission. The mean time to remission
was 130.81 days, and there was no difference in remission
frequency according to each treatment method. Patients
were followed up for 3.5~114.9 months (mean 40.86
months) and there was no recurrence in patients.
Conclusions:
Gastric MALT lymphoma is well associated with
helicobacter pyloric infection and showed high prevalence of
current infection (82.6%). However, the mucosal background
of gastric MALT lymphoma showed low prevalence of
atrophy and intestinal metaplasia, which in highly prevalent
of and precedent to adenocarcinoma. It suggests that
the pathogenic pathway of gastric MALY lymphoma and
adenocarcinoma has different directions. The treatment for
gastric MALT lymphoma varies according to kind of clinical
conditions, and the result could achieve clinical remission
regardless of treatment modalities.
Speaker Biography
Sang min Lee is a graduate of Kyungpook National University Medical School and has
completed his major training at the Department of Internal Medicine, the Catholic
University of Korea College of Medicine. Currently, he is in training for fellowship at
the Department of Internal Medicine of Yeouido St. Mary’s Hospital .He is majoring
in gastroenterology and is working to become the best Endoscopic specialist in South
Korea.
e:
sss-bluesky@hanmail.net