Gastric Lymphoma Research Articles

Endoscopic Features of Gastric Mucosa-Associated Lymphoid Tissue Lymphoma without Helicobacter pylori.

Although gastric mucosa-associated lymphoid tissue (MALT) lymphoma without Helicobacter pylori (HP) has increased recently, a specific endoscopic classification has not been established; its endoscopic characteristics have not been investigated. In this study, we retrospectively investigated gastric MALT lymphoma without HP in our hospital and assessed differences in the endoscopic findings according to HP infection status. Fifty-seven patients with gastric MALT lymphoma Lugano stage I, diagnosed between January 2013 and March 2023, were divided into three groups (currently HP infected, previously infected, and uninfected), wherein their endoscopic findings were evaluated. Furthermore, the superficial type, as per the classification of Sano et al., was independently subdivided based on the endoscopic differential diagnoses, as follows: atrophic gastritis-like, angiodysplasia-like, superficial gastritis-like, and undifferentiated carcinoma-like. Compared with the currently infected group, the HP-uninfected group tended to have more small lesions without erosion and more discolored, undifferentiated carcinoma-like depressed lesions. In addition, the positive rate of the tree-like appearance (TLA) and ballooning characteristics of gastric MALT lymphoma in magnified findings was lower in the HP-uninfected group. In patients without HP infection, MALT lymphoma should be excluded, even in the absence of suspicious magnifying findings such as TLA or ballooning.

Long Term Clinical Outcomes of Gastric Mucosa-Associated Lymphoid Tissue Lymphoma: A Single Center Study

Objectives: Few studies have reported long-term follow-up after treatment of gastric mucosaassociated lymphoid tissue (MALT) lymphoma. In this single-center study, we investigated longterm treatment outcomes in patients diagnosed with gastric MALT lymphoma.Methods: The study included 80 patients diagnosed with gastric MALT lymphoma, who were followed up at a single center between January 2005 and December 2019 after <i>Helicobacter pylori</i> eradication therapy, radiotherapy, or chemotherapy. We evaluated complete remission, improvement, or recurrence of the lesion. Follow-up over >60 months was classified as long-term follow-up, and the progression-free survival rate was recorded.Results: Following <i>H. pylori</i> eradication treatment, complete remission occurred in 85.9% (55/64) of <i>H. pylori</i>-positive and 50.0% (3/6) of <i>H. pylori</i>-negative patients. All patients with gastric MALT lymphoma who did not respond to <i>H. pylori</i> eradication therapy (100.0% [6/6]) achieved complete remission following administration of local radiotherapy. We observed no deaths on long-term follow-up (>60 months), and the progression-free survival was 101 months.Conclusions: In this study, patients with gastric MALT lymphoma showed excellent survival rates, progression-free survival, and prognosis on long-term follow-up. Prospective studies are warranted to determine the long-term prognosis of gastric MALT lymphoma after treatment.

Helicobacter Pylori and Sociodemographic Characteristics Distribution

Introduction and Aim: Helicobacter pylori is a gram-negative bacterium that affects up to half of the world's population, particularly in poorer nations. It is the leading cause of chronic gastritis, ulcers, gastric lymphoma, and gastric cancer, with more frequent cases in children and adolescents. Transmission can occur through fecal-oral, gastro-oral, oral-oral, or sexual means. The infection is caused by H. pylori's urease activity, invasion of host gastric epithelial cells, and adherence to host cell receptors. Early treatment can enhance gastric protection. Materials and Methods: Between November 2022 and July 2023, 103 samples were collected from patients at Mihrabani Surgical Hospital in Erbil City to identify Helicobacter pylori infection. Blood samples and stool samples were used to test for antibodies. Results: The study found a relatively equal gender representation in the patient and control groups, with 48.48% of men in the patient group and 48.64% in the control group. However, there are significant differences in age distribution, with G3 of age (<35) having the highest prevalence of H.pylori (48.48%). Additionally, 62.12% of patients are rural residents, while 97.29% of the control group are urban residents. Finally, 56.07% of patients are married, indicating a significant difference. Conclusion: The study found equal gender representation in patient and control groups but significant age differences, rural residency, and marital status, with G3 under 35 having the highest H.pylori prevalence.

Unveiling the Silent Intruder: H. pylori's Hidden Link to Ischemic Heart Disease.

Cardiovascular disease is the leading cause of death. In addition to the well-known risk factors associated with cardiovascular disease, such as age, diabetes mellitus, smoking, hypertension, and obesity, there has been a growing concern regarding cardiac complications stemming from the Gram-negative bacteria Helicobacter pylori. While H. pylori is most commonly associated with chronic gastritis, peptic ulcer disease, gastric adenocarcinoma, and gastric lymphoma, it has also been implicated in extra gastric manifestations, encompassing cardiac, neurologic, ocular, and dermatologic issues. Key virulent factors for coronary artery disease include the vacuolating cytotoxin gene A and the cytotoxin-associated gene A. The most likely pathogenic mechanism of the relationship between H. pylori and coronary artery disease is initiating a chronic inflammatory process associated with infection and the modifications of classic risk factors. These alterations lead to the creation of prothrombotic and procoagulant environments. Here, we review the cardiac manifestations of H. pylori and the underlying pathophysiological mechanisms.

WITHDRAWN: PIRES2-EGFP/CTB-UreI vaccination activated a mixed Th1/Th2/Th17 immune system defense towards Helicobacter pylori infection in the BALB/c mice model

The occurrence of gastritis, gastric ulcers, distal gastric cancer, and gastric mucosal lymphoma in humans is strongly associated with Helicobacter pylori (H. pylori). Vaccination is an effective preventive measure due to the increasing prevalence of antibiotic resistance. Fusion vaccination is a potentially practical approach. A fusion vaccine was created in this study by combining the cholera toxin B subunit (CTB) with the antigenic H. pylori urease I subunit (CTB-UreI). The CTB-UreI DNA vaccine was chemically cloned into pIRES2-EGFP, and the success of the cloning was validated using PCR and restriction enzyme digestion. An investigation was conducted on the induction of CTB-UreI in Escherichia coli BL21(DE3). The immunogenicity and immune-protective efficacy of the vaccination were assessed in BALB/c mice. The Western blot assay successfully identified the activation of CTB-UreI.In comparison, BALB/c mice receiving pIRES2-EGFP/CTB-UreI vaccination exhibited higher IgG, IgA, IFN-γ, IL-4, and IL-17 levels in their blood samples. In addition, there was a decrease in stomach injuries and bacterial loads. Furthermore, BALB/c mice inoculated with pIRES2-EGFP/CTB-UreI showed a high level of immunity (100%) against the H. pylori challenge. The pIRES2-EGFP/CTB-UreI elicited a combination of Th1/Th2/Th17 immune responses, possibly contributing to an effective defence mechanism. Our data suggests that using this fusion vaccine to prevent H. pylori infection is a promising option.

The role of baseline 2-[18 F]-FDG-PET/CT metrics and radiomics features in predicting primary gastric lymphoma diagnosis.

Diffuse Large B-Cell Lymphomas (DLCBL) and mucosa-associated lymphoid tissue (MALT) are the two most common primary gastric lymphomas (PGLs), but have strongly different features. DLBCL is more aggressive, is frequently diagnosed at an advanced stage and has a poorer prognosis. The aim of this retrospective study was to explore the role of fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (2-[18 F]-FDG-PET/CT) and radiomics features (RFs) in predicting the final diagnosis of patients with PGLs. Ninety-one patients with newly diagnosed PGLs who underwent pre-treatment 2-[18 F]-FDG-PET/CT were included. PET images were qualitatively and semi-quantitatively analyzed by deriving maximum standardized uptake value body weight (SUVbw), maximum standardized uptake value lean body mass (SUVlbm), maximum standardized uptake value body surface area (SUVbsa), lesion to liver SUVmax ratio (L-L SUV R), lesion to blood-pool SUVmax ratio (L-BP SUV R), metabolic tumor volume (gMTV) and total lesion glycolysis of gastric lesion (gTLG), total MTV (tMTV), TLG, and first-order RFs (histogram-related and shape related). Receiver-operating characteristic (ROC) curve analyses were performed to determine the differential diagnostic values of PET parameters. The final diagnosis was DLBCL in 54 (59%) cases and MALT in 37 cases (41%). PGLs showed FDG avidity in 83 cases (90%), 54/54 of DLBCL and 29/37 of MALT. All PET/CT metabolic features, such as stage of disease and tumor size, were significantly higher in DLBCL than MALT; while the presence of H. Pylori infection was more common in MALT. At univariate analysis, all PET/CT metrics were significantly higher in DLBCL than MALT lymphomas, while among RFs only Shape volume_vx and Shape sphericity showed a significant difference between the two groups. In conclusion we demonstrated that 2-[18 F]-FDG-PET/CT parameters can potentially discriminate between DLBCL and MALT lymphomas with high accuracy. Among first-order RFs, only Shape volume_vx and Shape sphericity helped in the differential diagnosis.

Long-term monitoring of gastric mucosa-associated lymphoid tissue lymphoma in patients with extra copies of the MALT1 gene

The objective of this study was to clarify the long-term prognosis of patients with gastric mucosa-associated lymphoid tissue (MALT) lymphoma with additional copies of MALT1. In this multicenter retrospective study, we enrolled 145 patients with gastric MALT lymphoma who underwent fluorescence in situ hybridization (FISH) analysis to detect t(11;18) translocation. The patient cohort was divided into three groups: Group A (n = 87), comprising individuals devoid of the t(11;18) translocation or extra MALT1 copies; Group B (n = 27), encompassing patients characterized by the presence of the t(11;18) translocation; and Group C (n = 31), including patients with extra MALT1 copies. The clinical outcomes in each cohort were collected. Over the course of a mean follow-up of 8.5 ± 4.2 years, one patient died of progressive MALT lymphoma, while 15 patients died due to etiologies unrelated to lymphoma. The progression or relapse of MALT lymphoma was observed in 11 patients: three in Group A, two in Group B, and six in Group C. In Groups A, B, and C, the 10-year overall survival rates were 82.5%, 93.8%, and 86.4%, respectively, and the 10-year event-free survival rates were 96.1%, 96.0%, and 82.9%, respectively. The event-free survival rate in Group C was significantly lower than that in Group A. However, no differences were observed in the 10-year event-free survival rates among individuals limited to stage I or II1 disease (equivalent to excluding patients with stage IV disease in this study, as there were no patients with stage II2), with rates of 98.6%, 95.8%, and 92.3% for Groups A, B, and C, respectively. In conclusion, the presence of extra copies of MALT1 was identified as an inferior prognostic determinant of event-free survival. Consequently, trisomy/tetrasomy 18 may serve as an indicator of progression and refractoriness to therapeutic intervention in patients with gastric MALT lymphoma, particularly stage IV gastric MALT lymphoma.

Distribution of Helicobacter pylori signal regions of vacA from infected patients of Benue State University Teaching Hospital Makurdi in relation to sex and age

Background: Helicobacter pylori is a Gram-negative bacterium which causes chronic bacterial infections such as gastritis, peptic ulcer, gastric cancers and gastric malt lymphoma. The severity of these diseases may be related to sex and age. The vacuolating cytotoxin A gene is a key virulence factor and exhibits genetic diversity most especially in its signal regions. The aim of the study was to assess the distribution of Helicobacter pylori signal regions of vavA from infected patients of Benue State University Teaching Hospital Makurdi in Relation to Sex and Age. Methods: A total of 80 patients referred for endoscopy were enrolled, and gastric biopsies taken from the antrum of the patients and tested by PCR then genotyped using standard techniques to identify the signal regions of the vacA gene. Demographic information, including age and sex, was recorded for each participant. Results: The frequency of H. pylori alleles of signal regions of vacA detected in biopsies showed that s1 had the highest frequency of 24 (100%) followed by s1c 22 (92%) while the least were s2 s1+s2. s1a was not detected. Presence of subspecie genotypes was not significantly associated with sex (Chi-square=6.511; p=0.089). However, the occurrence of the different subspecie was found to be significantly associated with age (Chi-square=21.343; p=0.011). Conclusion: The findings of this study show a relationship between H. pylori vacA sigma regions and demographic characteristics. The variations may be due to genetic variations, environmental factors, or a combination of both. H. pylori infection in the study was found not to be associated with gender but was significantly associated with age. Understanding this is crucial for discovering the complexity of H. pylori infections and developing targeted therapeutic strategies.

Vonoprazan: A Review in Helicobacter pylori Infection.

Treatment for the eradication of Helicobacter pylori infection, a leading cause of peptic ulcer disease and an important risk factor for gastric cancer and mucosa-associated lymphoid tissue lymphoma, is indicated whenever infection is identified. However, treatment success rates with current guideline-recommended proton-pump inhibitor (PPI)-based regimens remain suboptimal, with one potential factor associated with treatment failure being inadequate acid suppression. Vonoprazan (Voquezna®) is a first-in-class potassium-competitive acid blocker with the potential to provide potent and sustained acid suppression. Following clinical trials conducted mainly in Asia (supported by post-marketing experience from Asia) and the phaseIII PHALCON-HP trial conducted in the USA and Europe, vonoprazan is now approved in the USA for use in combination with amoxicillin (dual therapy) or amoxicillin and clarithromycin (triple therapy) for the treatment of H.pylori infection in adults. The vonoprazan-based dual and triple therapy regimens were generally well tolerated in PHALCON-HP. In addition, vonoprazan has advantages including a rapid onset of action and no food effect, making vonoprazan-based dual and triple therapy regimens valuable alternatives to standard PPI-based triple therapy in the treatment of H.pylori infection.

Эндоскопическая семиотика гастритоподобной формы первичных неходжкинских лимфом желудка

Aim. To characterize the main differentially significant endoscopic features specific to the gastritis-like form of primary gastric non-Hodgkin lymphomas (NHL).
 Materials & Methods. This prospective study analyzes the results of complex endoscopic diagnosis in 43 patients with primary gastric NHL. They were examined and treated at the NN Blokhin National Medical Cancer Research Center from 2019 to 2023. The patients were 30–70 years of age, those over the age of 50 predominated and accounted for 79 % (n = 34). There were 33 women and 10 men. The control group included 45 patients with gastritis-like malignant gastric tumors: adenocarcinoma and signet-ring cell cancer.
 Results. The morphological analysis yielded a diagnosis of MALT-lymphoma in 90.7 % (n = 39) and diffuse large B-cell lymphoma in 9.3 % (n = 4) of cases. Sensitivity, specificity, and accuracy of the clarification methods of complex endoscopic diagnosis were considerably higher compared to white-light mode examination. According to the results of complex endoscopic analysis, all patients were stratified into 4 groups with different types of H. pylori-induced atrophic gastritis (n = 10; 23.25 %), erosive gastritis (n = 10; 23.25 %), hyperplastic gastritis (n = 8; 18.6 %), and combined gastritis (n = 15; 34.9 %). The focus was laid on identifying the main differentially significant endoscopic features specific to the gastritis-like form of primary gastric NHL which distinguish it from the lesions in other malignant tumors.
 Conclusion. The complex examination using 4 concrete clarification methods of endoscopic diagnosis is indispensable to properly interpret the detected changes and timely diagnose the gastritis-like form of primary gastric NHL. These include narrow-band imaging (NBI/BLI and LCI), close-focus and magnification examinations, combined narrow-band imaging and magnification examination, as well as endosonography.

Helicobacter pylori Infection and Complications of Cirrhosis.

Helicobacter pylori is a significant contributor to conditions such as peptic ulcer disease, gastric cancer, gastric mucosa-associated lymphoid tissue lymphoma, and colorectal cancer. Recent studies have suggested a potential link between H. pylori and cirrhosis. However, the impact of H. pylori on cirrhosis-related mortality, inpatient outcomes, and decompensating events remains unclear. Considering the widespread availability of H. pylori testing and effective treatment options, there is a potential rationale for eradicating H. pylori in cirrhotic patients to mitigate the morbidity and mortality associated with cirrhosis. This study aims to investigate the association between H. pylori and inpatient outcomes and complications related to cirrhosis. The National Inpatient Sample (NIS) database, a part of the Healthcare Cost & Utilization Project, was utilized for this study. Inpatient data from the years 2016 through 2019 were extracted for patients with a primary discharge diagnosis of cirrhosis and a concurrent diagnosis of H. pylori infection. The primary outcomes included inpatient mortality, length of stay, and cost of care. Secondary outcomes involved cirrhosis-related complications during hospitalization, such as gastrointestinal bleeding, hepatic encephalopathy, and hepatorenal syndrome. Over the years 2016 to 2019, 416,410 patients received a primary discharge diagnosis of cirrhosis. Among them, 990 patients (0.2%) had a secondary diagnosis of H. pylori infection. Those with both cirrhosis and H. pylori tended to be younger on average (mean age 54.25 vs. 57.18 years, p=0.01) and more frequently fell within the age range of 18-49 (33.84% vs. 24.71%, P=0.01). H. pylori-infected patients were also more likely to be male (70.71% vs. 63.11%, P<0.028), of Hispanic race (36.4% vs. 18.6%, p< 0.1), and of Black race (20.2% vs. 8.1%, p< 0.1). While H. pylori-exposed patients had lower in-hospital mortality (0.51% vs. 4.44%, p=0.007), their mean length of stay was higher (6.97 days vs. 5.75, p=0.002). The overall cost of care was comparable between the H. pylori-exposed and non-exposed groups (mean USD18,106.18 vs. $16,543.49, P=0.160). H. pylori-exposed patients had a higher overall rate of cirrhosis-related complications (84.85% vs. 67.59%, p< 0.001), gastrointestinal bleeding (48.48% vs. 27.34%, p< 0.001), and hepatorenal syndrome (70.71% vs. 46.99%, p< 0.001), and these differences persisted in multivariable analysis. Initially, rates of hepatic encephalopathy were higher in H. pylori non-exposed patients (21.57% vs. 15.66%, p=0.04), but this discrepancy was corrected after adjusting for potential confounders. While patients in this study were diagnosed with both H. pylori and cirrhosis by discharge, it cannot be definitively concluded that H. pylori was the direct cause of cirrhosis complications. Recognizing this uncertainty, further studies are needed better to understand the associations between cirrhosis and H. pylori complications. Distinguishing the causes of cirrhosis and its relationship with H. pylori may offer deeper insights into whether H. pylori is a causative factor or merely correlated in its effects on patients with cirrhosis.

Gastric Burkitt Lymphoma, an Infrequent Cause of Hematemesis

Among gastric malignancies, lymphomas rank as the second most common type, following gastric adenocarcinoma. The majority of gastric lymphomas are either mucosa-associated lymphoid tissue lymphomas or diffuse large B-cell lymphomas. Primary gastric Burkitt lymphoma, is a subtype of non-Hodgkin's lymphoma, represents an exceptionally rare and aggressive malignancy, with only a limited number of reported cases globally. We present the case of a male patient with primary gastric Burkitt lymphoma revealed by digestive hemorrhage. The diagnosis was confirmed by endoscopy and gastric biopsies. The gastric localization of Burkitt's lymphoma is unusual. Our work is a review of the literature on Burkitt's lymphoma in its gastric localization.

Extranodal Marginal Zone Lymphoma of Mucosa Associated Lymphoid Tissue (MALT LYMPHOMA) With Extensive Plasma Cell Differentiation and Localized Amyloid Deposition.

Extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT) lymphoma is a mature and clinically indolent B cell lymphoma composed of heterogeneous cell population. Plasma cell differentiation is commonly seen in MALT lymphomas. However, plasmacytic differentiation along with localized amyloid deposition in the lungs is an extremely rare. We encountered a unique case of Extranodal MALT lymphoma with extensive plasmacytic differentiation and amyloid deposition. A 78-year-old female with past history of Gastric MALT lymphoma, status post chemotherapy presented in outpatient clinic. PET scan revealed an incidental 9 mm nodule in left lung, and subsequently underwent biopsy. Histology showed sheets of heterogeneous neoplastic cells including small lymphocytes, monocytoid cells, and abundant number of plasma cells (Fig A) in the background of hyalinization (Fig B). Immunohistochemical (IHC) reveals lymphoma cells are positive for CD20 (Fig C) and CD43, and plasma cells showed lambda restriction (Fig D). Furthermore, Congo Red stain of eosinophilic background showed positive birefringence upon polarization, consistent with Amyloid. Great caution is required in differentiating these cases from lymphoplasmacytic lymphoma as the histologic and IHC features can significantly overlap, and studies have also suggested that plasmacytic differentiation in these cases represent precursor neoplasm of plasma cells. Amyloid depositions in MALT lymphomas are rare and organ confined but can lead to local complications and cause considerable morbidity. Therefore, it is necessary to be aware of the association between MALT lymphoma with extensive plasma cell differentiation and amyloid deposition, as close clinical follow up is recommended.

Influence of Respiratory Motion on Dose Distribution in Gastric Mucosa-associated Lymphoid Tissue Lymphoma Radiotherapy.

The present study investigated the effect of respiratory motion on planned radiotherapy (RT) dose for gastric mucosa-associated lymphoid tissue (MALT) lymphoma using four-dimensional dose (4D-dose) accumulation. 4D-computed tomography (4D-CT) images of 10 patients with gastric MALT lymphomas were divided into 10 respiratory phases. Further, the 3D-dose was calculated using 3D conformal RT (3D-CRT) and volumetric modulated arc therapy (VMAT) plans based on the average intensity projection (AIP) images. Then, both plans were recalculated according to each phase image. Moreover, the dose distributions in each phase were transferred to the AIP images using deformable image registration. The 4D-dose distribution was calculated by summing the doses of each phase, and it was compared with the dosimetric parameters of the 3D-dose distribution. For 3D-CRT, the D95 and D99 of the 4D-dose in the planning target volume (PTV) were significantly lower than those of the 3D-dose, with mean differences of 0.2 (p=0.009) and 0.1 Gy (p=0.021), respectively. There were no significant differences in the other PTV and organ-at-risk dosimetric parameters of 3D-CRT or in any dosimetric parameters of VMAT between the 3D- and 4D-dose distributions. The effect of respiratory motion on the planned 3D-CRT and VMAT dose distributions for gastric MALT lymphoma is minimal and clinically negligible.

Helicobacter pylori infection diagnosis and management: current practices of Greek gastroenterologists.

The diagnosis and management of Helicobacter pylori (H. pylori) infection vary significantly, depending on country, area, and specialty. The aim of this study was to record the current practices of Greek gastroenterologists in the screening and treatment of H. pylori infection. An anonymous questionnaire consisting of 19 questions about the management of H. pylori infection was sent with the aid of the Hellenic Society of Gastroenterology to all members of the Society. The questionnaire was completed by 180 gastroenterologists, with a response rate of 31.4%. Diagnostic tests to confirm H. pylori infection are ordered by >90% of the gastroenterologists for patients with current peptic ulcer disease, gastric lymphoma, family history of gastric cancer, and an endoscopic appearance suggestive of gastritis. Most gastroenterologists (55.8%) also tested for H. pylori in patients with gastroesophageal reflux disease (GERD). Histopathology was the most preferred (60.6%) method when testing was decided during endoscopy, while urea breath test was the most preferred method (67.8%) regardless of endoscopy. Most gastroenterologists use quadruple eradication regimens supported by international guidelines (90%), while 65.6% of the physicians answered that they systematically recommend the addition of probiotics to standard therapy. Most physicians (82.8%) answered that they always confirm the eradication of the pathogen. The majority of Greek gastroenterologists conform to the recommendations of international guidelines regarding the diagnosis and management of H. pylori infection, except for the screening of patients with GERD. A considerable number of doctors use probiotics in addition to standard therapy.

Otros tumores gástricos: tumores del estroma gastrointestinal; tumores neuroendocrinos y linfoma gástrico

Although the most common stomach cancer is adenocarcinoma, there are other types of stomach cancers such as gastrointestinal stromal tumors (GIST), neuroendocrine tumors, and gastric lymphoma. Their onset has been linked to environmental factors. They usually progress asymptomatically until locally advanced stages, when they can give rise to a wide variety of symptoms. Upper gastrointestinal endoscopy with biopsy collection is the diagnostic method of choice. Other techniques such as echoendoscopy, computed tomography, or magnetic resonance imaging are used for staging. There are a variety of treatments ranging from endoscopic, such as mucosectomy or submucosal dissection, to surgical to systemic treatments.

MALT gastric lymphoma

MALT gastric lymphoma

FLI-1 is expressed in a wide variety of hematolymphoid neoplasms: a special concern in the differential diagnosis

Friend Leukemia Virus Integration 1 (FLI-1) is a member of E26 transformation-specific family of transcription factors that participates in hematopoietic and vascular endothelial cell development. Immunohistochemical detection of FLI-1 has been widely used to diagnose vascular tumors or, more evidently, Ewing’s sarcoma. However, the expression pattern of FLI-1 in hematolymphoid neoplasms remains unclear. Therefore, in this study, we aimed to investigate the expression of FLI-1 in these tumors, focusing on high-grade lesions, which presents a diagnostic challenge by mimicking Ewing’s sarcoma. We evaluated the expression FLI-1 in various types of lymphoid and plasmacytic tumors, including 27 plasmablastic lymphomas, 229 diffuse large B-cell lymphomas, 22 precursor T- or B-lymphoblastic lymphomas, 24 angioimmunoblastic-type nodal T-follicular helper cell lymphomas, 52 peripheral T-cell lymphomas, NOS, 18 Burkitt lymphomas, 18 non-gastric lymphomas of mucosa-associated lymphoid tissue, 38 chronic lymphocytic leukemia/small lymphocytic lymphomas, 15 mantle cell lymphomas, 23 gastric MALT lymphomas, 50 plasma cell myelomas, and 38 follicular lymphomas. We calculated the H-scores of FLI-1 immunostaining, ranging from 0 to 200, and used the scores to analyze the clinicopathological significance of FLI-1 statistically. FLI-1 was expressed to varying degrees in all types of hematological tumors. FLI-1 expression was detected in 84.1% of patients (466/554). FLI-1 was highly expressed in precursor T- or B-lymphoblastic lymphomas. Follicular lymphomas exhibited low FLI-1 expression. In plasmablastic lymphoma, 85.2% of the patients were focally positive for FLI-1. FLI-1 expression did not correlate with clinicopathological variables, such as demographic data or disease stage, in patients with plasmablastic lymphoma and diffuse large B-cell lymphoma. However, FLI-1 overexpression was associated with poorer overall survival in patients with plasmablastic lymphoma. This study demonstrates that FLI-1 is expressed in various hematolymphoid neoplasms. FLI-1 expression can lead to diagnostic confusion, especially in small blue round cell tumors, such as lymphoblastic lymphoma, plasmablastic lymphoma, and plasma cell myeloma, when distinguishing tumors positive for CD99 and CD56 without CD3, CD20, or CD45. Our findings also suggested the possibility of FLI-1 as a potential prognostic biomarker for plasmablastic lymphoma.

Exploring the inhibitory potential of in silico-designed small peptides on Helicobacter pylori Hp0231 (DsbK), a periplasmic oxidoreductase involved in disulfide bond formation.

Introduction: Helicobacter pylori is a bacterium that colonizes the gastric epithelium, which affects millions of people worldwide. H. pylori infection can lead to various gastrointestinal diseases, including gastric adenocarcinoma and mucosa-associated lymphoid tissue lymphoma. Conventional antibiotic therapies face challenges due to increasing antibiotic resistance and patient non-compliance, necessitating the exploration of alternative treatment approaches. In this study, we focused on Hp0231 (DsbK), an essential component of the H. pylori Dsb (disulfide bond) oxidative pathway, and investigated peptide-based inhibition as a potential therapeutic strategy. Methods: Three inhibitory peptides designed by computational modeling were evaluated for their effectiveness using a time-resolved fluorescence assay. We also examined the binding affinity between Hp0231 and the peptides using microscale thermophoresis. Results and discussion: Our findings demonstrate that in silico-designed synthetic peptides can effectively inhibit Hp0231-mediated peptide oxidation. Targeting Hp0231 oxidase activity could attenuate H. pylori virulence without compromising bacterial viability. Therefore, peptide-based inhibitors of Hp0231 could be candidates for the development of new targeted strategy, which does not influence the composition of the natural human microbiome, but deprive the bacterium of its pathogenic properties.

Awardee Summary of 2023 Taiwan Oncology Society Clinical Research Award Recipient: Persistent Endeavors on Research of Digestive Cancers for Three Decades

Abstract Objective: Digestive cancers account for five of the top ten cancer-related deaths in Taiwan. Our team has made persistent endeavors in translational research and clinical trials of digestive cancers for almost three decades. Data Sources and Study Selection: We enrolled relevant translational and clinical studies for digestive cancers published by our groups in the past three decades. Results: First, we developed a unique weekly 24-h infusion of high-dose 5-fluorouracil (5-FU) and leucovorin regimen (HDFL) in 1992. HDFL exhibits satisfactory single-agent activity, minimal myelosuppression, and mild toxicity. A variety of HDFL-based doublet combinations (such as cisplatin-HDFL, oxaliplatin-HDFL, and paclitaxel-HDFL) have become cornerstone regimens for three decades for the treatment of gastric cancers, with high efficacy and manageable toxicity at our hospital. Second, we have made persistent efforts in translational research and clinical trials on early-stage gastric mucosa-associated lymphoid tissue lymphomas (MALTomas), gastric diffuse large B-cell lymphomas, colorectal cancers (CRCs), pancreatic cancers, and immuno-oncology. Third, on behalf of the Taiwan Oncology Society, we participated in and published the Pan-Asian adapted European Society for Medical Oncology (ESMO) Clinical Practice Guidelines for locally advanced and metastatic CRC, gastric, and esophageal cancers, and the consensus meeting on tumor-agnostic indications of microsatellite instability-high (MSI-H) and NTRK. Conclusion: In the future, our team will make persistent endeavors in research on digestive cancers for immunotherapy and precision medicine to further improve treatment outcomes.