Gastric Mucosa-associated Lymphoma Research Articles

Advances in Helicobacter pylori vaccine research: From candidate antigens to adjuvants-A review.

Helicobacter pylori is a Gram-negative, spiral-shaped bacterium that infects approximately 50% of the world's population and has been strongly associated with chronic gastritis, peptic ulcers, gastric mucosa-associated lymphoma, and gastric cancer. The elimination of H. pylori is currently considered one of the most effective strategies for the treatment of gastric-related diseases, so antibiotic therapy is the most commonly used regimen for the treatment of H. pylori infection. Although this therapy has some positive effects, antibiotic resistance has become another clinically prominent problem. Therefore, the development of a safe and efficient vaccine has become an important measure to prevent H. pylori infection. PubMed and ClinicalTrials.gov were systematically searched from January 1980 to March 2023 with search terms-H. pylori vaccine, adjuvants, immunization, pathogenesis, and H. pylori eradication in the title and/or abstract of literature. A total of 5182 documents were obtained. Based on the principles of academic reliability, authority, nearly publicated, and excluded the similar documents, finally, 75 documents were selected, organized, and analyzed. Most of the candidate antigens used as H. pylori vaccines in these literatures are whole-cell antigens and virulence antigens such as UreB, VacA, CagA, and HspA, and the main types of vaccines for H. pylori are whole bacteria vaccines, vector vaccines, subunit vaccines, nucleic acid vaccines, epitope vaccines, etc. Some vaccines have shown good immune protection in animal trials; however, few vaccines show good in clinical trials. The only H. pylori vaccine passed phase 3 clinical trial is a recombinant subunit vaccine using Urease subunit B (UreB) as the vaccine antigen, and it shows good prophylactic effects. Meanwhile, the adjuvant system for vaccines against this bacterium has been developed considerably. In addition to the traditional mucosal adjuvants such as cholera toxin (CT) and E. coli heat labile enterotoxin (LT), there are also promising safer and more effective mucosal adjuvants. All these advances made safe and effective H. pylori vaccines come into service as early as possible. This review briefly summarized the advances of H. pylori vaccines from two aspects, candidates of antigens and adjuvants, to provide references for the development of vaccine against this bacterium. We also present our prospects of exosomal vaccines in H. pylori vaccine research, in the hope of inspiring future researchers.

An Incidental Finding of Gastric Mucosa-Associated Lymphoma (MALToma) in a Sleeve Gastrectomy with Literature Review

Mucosal-associated lymphoid tissue (MALT) lymphoma can typically be identified as a mass lesion or nodularity endoscopically and macroscopically. We report an incidental finding of a Helicobacter pylori gastric mucosal-associated lymphoid tissue (MALT) lymphoma in a sleeve gastrectomy specimen with no gross examination findings.

A case of Barrett\u2019s esophageal cancer with gastric mucosa-associated lymphoma

BackgroundAlthough the first-line therapy for early-stage gastric mucosa-associated lymphoid tissue lymphoma is the eradication of Helicobacter pylori, the effect of eradication in Helicobacter pylori-negative cases is unclear. In this case report, we describe a surgical option for a case of Barrett’s esophageal cancer with concurrent gastric mucosa-associated lymphoid tissue lymphoma.Case presentationA 79-year-old man was admitted to our hospital with Barrett’s esophageal cancer and gastric mucosa-associated lymphoid tissue lymphoma. Initially, we performed endoscopic submucosal dissection for Barrett’s esophageal cancer. Since residual tumor was observed after the endoscopic submucosal dissection, we performed an esophagectomy with two-field lymph node dissection, which was followed by placement of a gastric conduit via the posterior mediastinal route. He was discharged 14 days after surgery. Although no additional treatment exists for mucosa-associated lymphoid tissue lymphoma, no recurrent disease has been detected to date.ConclusionAn option to use a portion of the stomach with low-grade malignant mucosa-associated lymphoid tissue lymphoma as a conduit after esophagectomy was suggested.

Successful Treatment of a Patient With Gastric Mucosa-Associated Lymphoma

Successful Treatment of a Patient With Gastric Mucosa-Associated Lymphoma

Relationship between Helicobacter pylori infection and metabolic diseases

Helicobacter pylori infection is a common gastrointestinal infection, which is a major cause of chronic gastritis, peptic ulcer, stomach cancer and gastric mucosa-associated lymphoid tissue lymphoma and other diseases. In recent years, many studies show that Helicobacter pylori infection is closely related with many diseases, which may cause the retardation of children development and affect blood lipids and glucose metabolism. Helicobacter pylori infection may also lead to chronic inflammatory process, results in a large number of cytokines and play an important role in artery atherosclerosis. This paper reviews on the correlation between Helicobacter pylori infection and metabolic diseases and its mechanism as well. Key words: Helicobacter pylori; Metabolic diseases

Review of Research on Routes of Helicobacter pylori Infection

AbstractIn recent years, many scholars conducted in-depth research onHelicobacter pyloriand identified it as an important pathogen of chronic gastritis and peptic ulcer.H. pylorialso causes also and contributes to precancerous lesions (atrophic gastritis and intestinal metaplasia) and is closely related to occurrence and development of gastric adenocarcinoma and gastric mucosa-associated lymphoma. This study summarizes biological characteristics, epidemic status, and infection route ofH. pyloriand reviews research on roles of natural environments, especially drinking water, during infection.

A Case of Simultaneous Primary Gastric and Duodenal Mucosa-Associated Lymphoid Tissue Lymphoma after Therapeutic Endoscopy

원발성 위 MALT 림프종은 흔하지만 원발성 십이지장 MALT 림프종은 드물며, 위와 십이지장을 동시에 침범한 MALT 림 프종은 매우 드물다. 위와 십이지장의 MALT 림프종의 보고 는 국내와 국외의 증례를 합하여 총 5예에 불과하다. 지금까 지 보고된 증례가 많지 않아 위와 십이지장 MALT 림프종을 동시에 효과적으로 치료할 수 있는 명확한 치료 방침이 없 지만, 저등급 MALT 림프종의 경우에는 첫 치료로 H. pylori 제균을 시도해 볼 수 있고, 추가적으로 항암화학요법 및 방 사선 치료를 고려해 볼 수 있겠다.

Efficacy and safety evaluation of gemcitabine combined with oxaliplatin in lymphoma patients after failure of multiple chemotherapy regimens

To evaluate the efficacy and safety of gemcitabine combined with oxaliplatin (GEMOX) in lymphoma patients after failure of multiple chemotherapy regimens. The clinical data of 27 lymphoma patients, who received GEMOX regimen after failure of two or more prior chemotherapy regimens, were retrospectively reviewed. The predictive factors related to the clinical efficacy of GEMOX regimen were explored. The efficacy could be evaluated in 24 patients. Complete response was obtained in 4 patients (16.7%), partial response in 7 patients (29.1%), stable disease in 6 patients (25.0%), and progressive disease in 7 patients (29.1%), with an overall response rate of 45.8%. Among the eleven CR and PR patients, four patients were with diffuse large B cell lymphoma, four patients with Hodgkin's lymphoma, one with peripheral T cell lymphoma, one with mantle cell lymphoma and one with gastric mucosa-associated lymphoid tissue lymphoma. The median PFS time of the whole group was 8 months (95%CI, 1.6-14.4 months). For 11 CR and PR patients who had response to the GEMOX regimen, the median PFS time was 19 months (95%CI, 11.1-26.8 months). Major adverse response was hematologic toxicity. Among them, grade III or IV neutropenia appeared in 16 patients (59.3%), and grade III or IV thrombocytopenia appeared in 11 patients (40.7%). The sensitivity to the last chemotherapy was related to the efficacy of GEMOX regimen. The response rate was 83.3% in patients who had response to the last chemotherapy, and only 31.2% in the patients who failed to the last chemotherapy (P = 0.001). GEMOX regimen can get a better response rate in lymphoma patients after failure of multiple chemotherapy regimens, and with a good tolerance and acceptable safety. Some patients can get long-term survival. Patients sensitive to the last chemotherapy are more likely to benefit from GEMOX regimen.

Letter: is Helicobacter pylori behind Barrett's oesophagus and colorectal neoplasms? Authors’ reply

We thank Dr Kountouras and colleagues for their interest in our article.1, 2 The role of Helicobacter pylori in the development of peptic ulcers, as well as gastric adenocarcinomas and gastric mucosa-associated lymphomas (MALT lymphomas), is now widely accepted.3 The idea that the same pathogen could be involved in the pathogenesis of both Barrett's oesophagus (BO) and colonic tumours is intriguing. The recent findings by Zhang et al.4 showing an adjusted odds ratio of 1.18 (95% CI: 1.01–1.38) between H. pylori infection and colorectal cancer points to a potential association between the two. Furthermore, a meta-analysis5 of 13 studies from 2008 also showed a positive association, with an odds ratio of 1.49 (95% CI: 1.17–1.91). However, studies by Abbass et al.6 (published after the meta-analysis by Zhao et al.3 and therefore not included in the analysis) and Siddheshwar et al.7 found no association. Given the uncertainty at present, more studies are needed to confirm the relationship, should one exist, as well as a mechanistic explanation. The authors’ declarations of personal and financial interests are unchanged from those in the original article.2

Gastric mucosa-associated lymphoid tissue lymphoma: A clinical analysis of 42 patients

Gastric mucosa-associated lymphoid tissue lymphoma: A clinical analysis of 42 patients

Clinicopathological analysis of gastric mucosa-associated lymphoid tissue lymphoma

Objective To analyze the clinicopathological characteristics, immunophenotypes and immu-noglobulin heavy chain gene rearrangement of gastric mucosa-associated lymphoid tissue (MALT) lymphoma. Methods The clinical data of 35 patients with gastric MALT lymphoma who had been admitted to Southwest Hospital from January 1984 to June 2003 were retrospectively analyzed. The specimens of the gastric MALT lymphoma were obtained and their pathomorphological classifications were studied. The immunophenotypes and immunoglobulin heavy chain gene rearrangement were detected by immunohistochemistry and polymerase chain reaction, respectively. All the data were analyzed by chi-square test and Mann-Whitney U test. Results The main manifestations of patients with gastric MALT lymphoma were epigastric discomfort and abdominalgia. The percentage of patients with age≥40 accounted for 74% (26/35). The gastric MALT lyrnphoma has low differentia-tion in 32 patients, and high differentiation in 3 patients. There were 31 patients in Ⅰ E stage, 2 in Ⅱ E1 stage and 2 in Ⅳ stage. Pathological examination showed that gastric MALT lymphoma was composed of centrocyte-like cells and mononuclear-like B cells or lymphoplasma cells. Twenty-nine specimens were with lymphoepithelial lesions (83%), 2 with follicular colonization (6%), and 11 with plasma cells segregated beneath the surface epithelium (33%). All the 35 specimens were B cell immunotype. Restrictive expression of κ and λ light chains of the immunoglobulin was found in 19 cases, and Bcl-2 positive expression was found in 16 cases. High expres-sion of proliferating cell nuclear antigen was found in gastric MALT lymphoma with transformed blasts, which indicated that gastric MALT lymphoma with transformed blasts was more active in proliferation than those of low grade. A monoclonal pattern of immunoglobulin heavy chain gene rearrangement was detected in 33 patients (94%). Conclusions Digestive symptoms are the main manifestations of patients with gastric MALT lymphoma. The incidence of gastric MALT lymphoma increases with age. The final diagnosis of gastric MALT lymphoma depends on the pathological, immunohistochemical examination and laboratory test. Key words: Lymphoma; Mucosa-associated lymphoid tissue; Pathology; Immune phenotype

Clinical outcome andprognostic factors of primary gastric mucosa-associated lymphoid tissue lymphoma: aretrospective analysis of 77 cases

：Objective To analyze theclinical results and prognostic factors of patients with early-stage primary gastricmucosa-associated lymphoid tissue(MALT) lymphoma. Methods Seventy-seven pa-tients withprimary gastric MALT lymphoma treated from 1985 to 2006 were retrospectively analyzed. Allpa-tients were pathologically confirmed as MALT lymphoma in stage Ⅰ ,Ⅱ and Ⅱ_E (by modified Blackedgestaging system). Thirty-seven patients had stage Ⅰ disease,23 stage Ⅱ and 17 stage Ⅱ_E.Sixty patients un-derwent surgical resection and 17 received non-surgical treatment.Survival rates were calculated by the Kap-lan-Meier analysis with the Logrank test.Results With a median follow up of 57 months for the surviving patients(ranging from 1 to198 months for all patients), the 5-year overall survival rate, disease-free survivalrate,loco-regional control rate and distant metastasis free survival rate were 74%,70%,76% and 87% ,re-spectively. In univariate analysis, clinical stage was significantlyassociated with overall survival. Patients with stage Ⅰ or Ⅱ disease had a better overallsurvival than those with stage Ⅱ_E (P = 0.01). Tumor size andsurgical resection were significantly associated with disease-free survival. Patients withprimary tumor 8 cm or less in diameter had better disease-free survival than those withprimary tumor more than 8 cm in diameter(P =0.03). Patients who underwent completeresection had better disease-free survival than those who under-went incomplete resectionor no surgery (P =0.02). Clinical stage, tumor size and surgical resection weresignificantly associated with loco-regional control. Patients with stage Ⅰ or Ⅱ disease had betterloco-regional control than those with stage Ⅱ_E (P = 0. 03). Patients withprimary tumor 8 cm or less in diameter had better loco-regional control than those withprimary tumor more than 8 cm in diameter(P =0.01). Patients who un-derwent completeresection had better loco-regional control than those who underwent incomplete resectionor no surgery(P=0.03). Patients with stage Ⅰand Ⅱ disease treated with surgery had more local recurrence, andpatients treated without surgery tended to recur systematically. Patients with stageⅡ_E disease tended torecur locally in spite of surgery or not. Conclusions The efficacy of surgical andnon-surgical treatment for primary gastric MALT lymphoma are similar. Surgical resectionis no longer a necessary approach in the primary treatment. Clinical stage is an importantprognostic factor for primary gastric MALT lymphoma. Key words: Lymphoma; gastric mucosa-associated lymphoid tissue/surgery; Lymphoma; gastric mucosa-associated lymphoid tissue/radio-chemotherapy; Prognosis

Microcirculatory alteration in low‐grade gastric mucosa‐associated lymphoma by Helicobacter heilmannii infection: Its relation to vascular endothelial growth factor and cyclooxygenase‐2

There are clinical reports that Helicobacter heilmannii, as well as Helicobacter pylori, has been clinically reported to cause gastric low-grade mucosa-associated lymphoid tissue-type (MALT) lymphoma, although its precise mechanism remains to be clarified. Thus, the present study was undertaken to elucidate the alteration of the microcirculatory structure and the relation to angiogenetic factors in mice infected with H. heilmannii for 3 and 6 months. Immunohistochemical studies have been performed by FITC-dextran intra-aortic infusion or CD31, vascular endothelial growth factor-A, cyclooxygenase 2 antibodies using our recently established model of gastric mucosa-associated lymphoid tissue-type gastric B-cell lymphoma in C57BL/6 mice. Increased microcirculatory network was recognized surrounding the MALT lymphoma tissues by both the FITC-dextran infusion method and CD31 immunoreactivity. Vascular endothelial growth factor-A immunoreactivity was recognized within the lymphoma tissues as well as in the marginal area, while cyclooxygenase-2 immunoreactivity was localized in the area surrounding the MALT lymphoma tissues. Increased microvascular network as well as enhanced VEGF-A immunoreactivity was shown to be related to expansion of the MALT lymphoma formed by Helicobacter heilmannii infection.

Economic perspectives in the management of Helicobacter pylori infections.

The infection with Helicobacter pylori contributes to the occurrence of at least four diseases, that is, gastric ulcer, duodenal ulcer, gastric cancer and gastric mucosa-associated lymphoma tissue lymphoma. Many gastroenterologists believe that infection with H. pylori can also result in epigastric symptoms and nonulcer dyspepsia. The health economics of H. pylori infection relates to the cost-benefit relationship of preventing, treating or curing these various conditions through medical measures directed against the infectious organism. In addition, economic analyses have addressed various other aspects of diagnosis and management of patients infected with H. pylori. A minority of analyses were based on real data generated from prospective clinical trials or retrospective analysis of utilization of health care resources, while the majority of studies used economic modeling to predict the influence of various medical measures. The models used mostly decision trees, Markov chains, the declining exponential approximation of life expectancy (DEALE), and the accounting technique of net present value. The following three sections of the present chapter are focused towards the management of the three most common conditions associated with H. pylori, that is, peptic ulcer, gastric cancer, and nonulcer dyspepsia. In a subsequent section we discuss the workup of patients with upper abdominal symptoms and a few other economic issues related to the management of patients infected with H. pylori.KeywordsGastric CancerAntibiotic TherapyPeptic UlcerDuodenal UlcerPylorus InfectionThese keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.