文章：

胃幽门螺杆菌相关弥漫性大B细胞淋巴瘤：侵袭性较低，化疗敏感性较高

Helicobacter pylori-related diffuse large B-cell lymphoma of the stomach: a distinct entity with lower aggressiveness and higher chemosensitivity

原文发布日期：2014-06-20

DOI: 10.1038/bcj.2014.40

类型: Original Article

开放获取: 是

英文摘要：

We recently showed that Helicobacter pylori (HP)-positive gastric ‘pure’ diffuse large B-cell lymphoma (DLBCL) may respond to HP eradication therapy. However, whether these HP-related ‘pure’ DLBCL of the stomach may differ fundamentally from those unrelated to HP remains unclear. In this study, we compared the clinicopathologic features of these two groups of patients who had been uniformly treated by conventional chemotherapy. Forty-six patients were designated HP-positive and 49 were HP-negative by conventional criteria. HP-positive patients had a lower International Prognostic Index score (0–1, 65% vs 43%, P=0.029), a lower clinical stage (I-IIE1, 70% vs 39%, P=0.003), a better tumor response to chemotherapy (complete pathologic response, 76% vs 47%, P=0.004) and significantly superior 5-year event-free survival (EFS) (71.7% vs 31.8%, P<0.001) and overall survival (OS) (76.1% vs 39.8%, P<0.001). To draw a closer biologic link with HP, HP-positive tumors were further examined for CagA expression in lymphoma cells. Compared with CagA-negative cases (n=16), CagA-positive cases (n=27) were associated with high phosphorylated SHP-2 expression (P=0.016), and even better 5-year EFS (85.2% vs 46.3%, P=0.002) and OS (88.9% vs 52.9%, P=0.003). HP-related gastric ‘pure’ DLBCL may be a distinct tumor entity, which is less aggressive, and responds better to conventional chemotherapy.

摘要翻译： 

我们近期发现幽门螺杆菌阳性的胃"单纯性"弥漫大B细胞淋巴瘤可能对根除幽门螺杆菌治疗产生应答。然而，这些与幽门螺杆菌相关的胃"单纯性"弥漫大B细胞淋巴瘤是否与幽门螺杆菌阴性者存在本质差异尚不明确。本研究比较了这两组均接受常规化疗患者的临床病理特征。根据常规标准，46例患者被确定为幽门螺杆菌阳性，49例为阴性。幽门螺杆菌阳性患者的国际预后指数评分较低（0-1分者占65% vs 43%，P=0.029），临床分期较低（I-IIE1期者占70% vs 39%，P=0.003），对化疗的肿瘤反应更佳（病理学完全缓解率达76% vs 47%，P=0.004），且5年无事件生存率（71.7% vs 31.8%，P<0.001）和总生存率（76.1% vs 39.8%，P<0.001）显著更优。为建立与幽门螺杆菌更紧密的生物学联系，我们进一步检测了幽门螺杆菌阳性肿瘤淋巴瘤细胞中CagA的表达。与CagA阴性病例（n=16）相比，CagA阳性病例（n=27）与高磷酸化SHP-2表达相关（P=0.016），并具有更优的5年无事件生存率（85.2% vs 46.3%，P=0.002）和总生存率（88.9% vs 52.9%，P=0.003）。幽门螺杆菌相关性胃"单纯性"弥漫大B细胞淋巴瘤可能是一种独特的肿瘤实体，其侵袭性较低，对常规化疗反应更佳。

原文链接：

Helicobacter pylori-related diffuse large B-cell lymphoma of the stomach: a distinct entity with lower aggressiveness and higher chemosensitivity