Primary Gastric Lymphoma Research Articles

Gastric MALT lymphoma presented with primary perforation in an adolescent: a case report

BackgroundPrimary lymphomas of the gastrointestinal tract are rare, accounting for only 1 to 4% of malignancies arising in the stomach, small intestine, or colon. The stomach is the most common extranodal site of lymphoma and gastric mucosa-associated lymphoid tissue (MALT) lymphoma accounts for 40% of primary gastric lymphoma. Gastric MALT lymphoma reaches its peak incidence between 50 to 60 years of age, therefore, it is rarely encountered in pediatric population. The presenting symptoms of gastric MALT lymphoma are usually nonspecific and primary perforation of gastric MALT lymphoma is uncommon.Case presentationA 12 year-old female presented with iron deficient anemia developed gastric perforation. Emergency laparoscopic repair of the perforation was performed and tissue pathology showed gastric MALT lymphoma infiltration. Helicobacter pylori eradication and radiotherapy were sequentially performed. Complete remission was achieved at two months after radiotherapy. To our best knowledge, she is the youngest patient with gastric MALT lymphoma reported in the literature.ConclusionIron deficient anemia is a common presenting manifestation of malignancies in adulthood. In pediatric population, iron deficient anemia is usually caused by nutritional deficient or blood loss. In this case report, we present a teenaged female without previous gastric ulcer history who presented with a rare gastric tumor and an uncommon primary perforation. Even if there is an uncertainty about the exact diagnosis prior to the surgery, the strategy of stomach-preserving therapy by laparoscopy for primary perforation was successful and provided a good quality of life.

Gastric lymphoma and gastric tuberculosis: A diagnostic dilemma

AbstractGastric outlet obstruction may be caused by a heterogeneous group of diseases that include both benign and malignant conditions. Primary gastric lymphoma (3%–5% of all gastrointestinal malignancies) and primary gastric tuberculosis (TB) (0.4%–2%) are very rare and resemble each other in clinical presentation with diagnostic dilemma between them. Do the two entities exist concomitantly or precede each other is still a topic of debate in the literature. Here, we present a case of primary gastric TB and gastric lymphoma in the same patient.

Clinical Efficacy of Radiotherapy in Helicobacter pylori Negative or Unresponsive to Eradication Therapy Primary Gastric Mucosa-Associated Lymphoid Tissue Lymphoma

The eradication of Helicobacter pylori (H. pylori) is an effective treatment in gastric mucosa-associated lymphoid tissue (MALT) lymphoma associated with H. pylori infection. However, the treatment strategy in gastric MALT lymphoma patients who are H. pylori-negative or unresponsive to H. pylori eradication therapy remains controversial. In this study, we investigated the clinical efficacy of treatments other than H. pylori eradication therapy in these groups of patients. This was a retrospective single-center study based on the medical records of patients diagnosed with gastric MALT lymphoma at Yeungnam University Medical Center between January 2005 and December 2016. Patients were treated with H. pylori eradication therapy, chemotherapy, or radiotherapy according to their H. pylori infection status and stage of gastric MALT lymphoma. Of the 68 eligible patients, 50 were enrolled in the study. Of the 42 patients with H. pylori-positive gastric MALT lymphoma, 36 (81.7%) were treated with H. pylori eradication therapy as primary treatment and 25 (69.4%) achieved a complete response (CR). Patients without a CR after H. pylori eradication therapy (n=11, 30.6%) received radiotherapy as a secondary treatment. Two patients with H. pylori-positive gastric MALT lymphoma and eight with H. pylori-negative gastric MALT lymphoma received radiotherapy as the primary treatment. CR was achieved in all 21 patients treated with radiotherapy as primary or secondary treatment. The 5-year progression-free survival rate after radiotherapy was 92.9%. Radiotherapy may be a worthwhile treatment option in patients with H. pylori-negative MALT lymphoma or H. pylori-positive MALT lymphoma that is not responsive to H. pylori eradication therapy.

Primary gastric diffuse large B-cell lymphoma: The role of dose-dense chemotherapy.

To assess if the use of a dose-dense regimen of chemotherapy can improve the prognosis in patients with primary gastric diffuse large B-cell lymphoma in early stages (I-II) but associated with worse prognostic factors. One hundred and eight consecutive patients with primary gastric diffuse large B-cell lymphoma in early stages (I-II) with high serum levels of lactic dehydrogenase and beta 2 microglobulin (more than >2 of normal levels), which were associated with a worse prognostic outcome, were treated with a dose-dense chemotherapy: CHOP with increased doses of cyclophosphamide and doxorubicin, was administered every 14 days (instead of 21 days). The end points of this study were to improve outcome measured from progression-free survival and overall survival and to evaluate acute toxicities. Complete response was achieved in 85 patients (78%). Actuarial curves at five years show that progression-free survival was 82% and overall survival was 85%. Hematological toxicities were severe, but no death-related treatment was observed. We considered that in this setting of patients, the use of a dose-dense regimen could be of benefit because it improves outcome and toxicities were well controlled.

Primary Gastric Diffuse Large B-Cell Lymphoma Treated with Abbreviated Chemoimmunotherapy and Contemporary Radiation Therapy has Excellent Outcomes with Minimal Toxicity

The gastrointestinal tract is the most common location for extranodal involvement of diffuse large B-cell lymphoma (DLBCL). We sought to evaluate outcomes and toxicities for patients with primary gastric DLBCL, treated with modern radiation therapy (RT). We performed dosimetric comparisons for two motion management strategies (4-dimensional computed tomography, 4DCT and deep inspiration breath hold, DIBH), in an effort to define the utility of advanced RT techniques. We evaluated 20 patients treated at a single institution with chemoimmunotherapy and involved site radiation therapy (ISRT) for early stage (IE – IIE) gastric DLBCL from 2009 to 2016. We included patients who had response on PET-CT during or after chemoimmunotherapy. We measured progression free survival (PFS), overall survival (OS), and local control (LC) using the KM method. Toxicities were extracted from the medical chart per CTCAE v4.0. Additionally, we report dosimetric parameters for patients treated to an internal target volume (ITV) created using 4DCT versus several DIBH images. We specifically examined dose to the heart (mean, V30, V20, V10, and V5). A paired two sided t-test was performed to compare these results. The median age was 66 years (IQR: 54 – 77), 13 patients (65%) had stage I disease. 90% of patients received R-CHOP and 10% (n=2) received dose adjusted R-EPOCH. The median number of chemotherapy cycles was 4, 55% (n=11) had 3-4 cycles of chemotherapy and 45% (n=9) had 6 cycles. All patients were treated with intensity modulated radiation therapy (IMRT) and image guided radiotherapy (IGRT, CT in 18, kV in 2). The median RT dose was 30.6 Gy (range 30-36 Gy). The median follow up for the cohort from date of diagnosis was 42 months (IQR: 27 – 69). At 4 years, the PFS, OS, and LC for the cohort were 82%, 89%, and 100% respectively. Only one patient experienced relapse (thyroid gland). Two patients died due to intercurrent disease. There were no grade 2 or higher acute toxicities. One patient developed a late grade 3 gastric outlet obstruction. The CTV comprised the entire stomach. For five patients, ITVs were generated using both 4DCT and DIBH CT images. A uniform 1 cm PTV expansion was used. Using 4DCT instead of DIBH images for planning resulted in significant increases in cardiac doses. The mean heart dose for DIBH was 2.9 Gy compared to 5 Gy for 4DCT (p=0.04). The volume of the heart that received 10 Gy and 5 Gy was also increased for 4DCT (p=0.04 and p=0.03, respectively). For early stage gastric DLBCL, chemoimmunotherapy followed by ISRT yields excellent outcomes, even after abbreviated systemic therapy. Radiation was well tolerated with minimal reported toxicity using modern IMRT/IGRT. IMRT delivered with DIBH can significantly reduce cardiac doses and should be considered at centers with breath hold technology.

Trends in Survival of Patients with Primary Gastric Diffuse Large B-Cell Lymphoma: An Analysis of 7051 Cases in the SEER Database.

Treatment modalities for primary gastric diffuse large B-cell lymphoma (PG-DLBCL) have changed significantly during the past decades. However, limited information on the trends of clinical outcome of PG-DLBCL patients has been reported. Here, we conducted a retrospective analysis using the Surveillance, Epidemiology, and End Results (SEER) database to compare the survival trends of PG-DLBCL patients from 1973 to 2014. Patients were divided into 2 eras based on the year of diagnosis in relation to immunotherapy with the anti-CD20 antibody rituximab that was approved in 1997 and became a widely used drug in 2000. There was a significant improvement in survival among PG-DLBCL patients diagnosed in the 2001–2014 era (n = 4186) compared to patients diagnosed in the 1973–2000 era (n = 2865), with the 5-year overall survival rates of 53% and 47%, respectively (p = 0.001). Multivariable analysis revealed that the 2001–2014 era (HR = 0.892, p = 0.001) was associated with lower mortality and that patients of older age, Black race, advanced stage, and male gender were associated with poor prognosis. Although outcome of PG-DLBCL has significantly improved over time, more effective therapies are needed for older patients to further improve their survival.

The size and depth of lesions measured by endoscopic ultrasonography are novel prognostic factors of primary gastric diffuse large B-cell lymphoma

Diffuse large B cell lymphoma is one of the predominant histological subtypes of primary gastric lymphomas. Factors that contribute to precise stratification and guide the treatment of this disease are still not well understood. We analyzed 73 primary gastric diffuse large B cell lymphoma patients retrospectively, and found that patients characterized by late stage, multiple localization, B symptoms, lower serum albumin level and elevated LDH level had a shorter overall survival through Univariate Cox regression analysis. Multivariate Cox regression analysis demonstrated that ALB ≤ 35g/L, staging ≥ IIE and multiple sites localization were independent adverse prognostic factors. Significantly, in 35 patients who received endoscopy at diagnosis, Kaplan–Meier analyses indicated that patients with large (≥3 cm) and deep lesions (≥11 mm) had an inferior OS (p = .01 and .039). These findings implicated that tumor size and depth are two indicators of prognosis under ultrasonography. Further randomized studies with large number of cases are needed.

A Case of Primary Gastric Lymphoma in Immunocompomised Patient

A Case of Primary Gastric Lymphoma in Immunocompomised Patient

A Case of Primary Gastric Lymphoma in Immunocompetent Patient

A Case of Primary Gastric Lymphoma in Immunocompetent Patient

Progress of primary intestinal lymphoma

The incidence of primary intestinal lymphoma (PIL) in primary gastrointestinal lymphoma (PGIL) is much lower than that of primary gastric lymphoma (PGL). Treatment strategies for PGL have been normalized, but there are still controversies concerning about the diagnosis criteria and optimal treatment of PIL. The lesions are mainly found in intestinal tract, and the most common involvement is ileocecal junction. The pathological types are derived from B-cell and diffuse large B-cell lymphoma (DLBCL) is the most common type, followed by extra-nodal marginal zone lymphoma of mucosa-associated lymphoid tissue. Surgery, chemotherapy, radiotherapy, antibiotics and monoclonal antibody therapy could be used as the monotherapy or different combined therapies, however, the final conclusion has not been reached in the treatment of PIL, accompanied by various influencing factors for prognosis. This review discusses the diagnosis criteria, clinical features, optimal treatment and prognostic factors of PIL. The diagnosis criteria and the optimal treatment will be put more emphasis. Key words: Gastrointestinal tract; Lymphoma, B-cell; Lymphoma, T-cell; Prognosis

Clinical characteristics and treatment strategies for early-stage primary gastric diffuse large B-cell lymphoma

Objective: Primary gastric diffuse large B-cell lymphoma (PG-DLBCL) is the most common non-Hodgkin lymphoma (NHL) of extranodal origin. Most patients with PG-DLBCL had localized disease (stage Ⅰ or Ⅱ) at presentation, and will achieve complete response (CR) after induction chemotherapy. However, there has been little consensus regarding whether optimal treatment is provided by chemotherapy alone or chemotherapy plus radiotherapy, nor the treatment outcome from the addition of rituximab in localized-stage PG-DLBCL. Methods: Patients with Stage ⅠE and ⅡE PG-DLBCL were retrospectively analyzed. Patients have not undergone surgery, have received at least 3 cycles of R-CHOP or CHOP-like chemotherapy as initial therapy, and achieved CR or partial response (PR) were enrolled. Results: A total of 91 patients were studied. The median age was 51 years, included 47 males and 44 females. Fifty-two patients were at Stage ⅠE and 39 at Stage ⅡE, 64 (70.3%) patients received R-CHOP-like regimens, and 27 (29.7%) received CHOP-like regimens, the median chemotherapy cycle was 6 (3-8). Among the 91 patients, 80 (87.9%) patients achieved CR from induction chemotherapy, 11(12.1%) was evaluated PR. Of CR patients, 48 patients (60%) underwent consolidating radiotherapy and 32 patients (40%) did not receive radiotherapy; all PR patients received salvage radiotherapy. CR patients with and without radiation therapy had 4-year progression-free survival (PFS) rates of 96.4% and 96.7%, respectively (χ(2) = 0.546, P=0.46); 7/11 (63.6%) PR patients achieved CR after radiotherapy, with a median follow-up of 41 months, they were all disease free. For patients treated with R-CHOP or CHOP-like regimens, the 4-year PFS was 93.2% and 89.7%, respectively (χ(2)=0.096, P=0.757). Conclusions: Consolidation radiotherapy failed to improve the outcome for early-stage PG-DLBCL, while for PR patients, salvage radiotherapy increased CR rate and improved survival. The addition of rituximab to CHOP did not improve the efficacy.

Primary gastric lymphoma: A study of morphology, immunophenotype, and prevalence of Helicobacter pylori infection

Objectives: We aimed to study the pattern of primary gastric lymphoma in two geographically different locations, namely, Tripoli Medical Center (TMC) in Libya and Antwerp University Hospital (Universitair Ziekenhuis Antwerpen [UZA]) in Belgium. Materials and methods: Twenty-four cases of primary gastric lymphoma diagnosed during an 8-year period at TMC and 20 cases diagnosed during 11-year period in UZA were studied. Immunohistochemistry lymphoma panel CD3, CD5, CD20, CD10, CD79a, CyclinD1, KI67, and pancytokeratin were applied in all cases. Results: Primary gastric lymphoma in UZA occurs in a slightly older age group with marked male predominance while in TMC occurs at a slightly younger age with marginal male predominance. Two-thirds of the TMC cases were of high-grade lymphoma (HGL) and one-third were low-grade lymphoma (LGL). UZA cases included nine cases of HGL with (45%) and 11 of LGL (55%). Of the TMC primary gastric lymphoma cases, 12 were infected with Helicobacter pylori (50%) and eight cases were mucosa-associated lymphoid tissue lymphoma (MALT-L) of which three cases had H. pylori infection. In the UZA cases, H. pylori infection was evident in seven of 20 primary gastric lymphoma cases (35%) and three of six MALT-L had H. pylori-infected cases (50%). Conclusions: This comparative study of primary gastric lymphoma in TMC (Libyan) and UZA (Belgian) studied cases showed no marked differences between the two patient populations based on the histological features and immunohistochemical phenotype and genotype and the clinical features.

Primary Gastric Lymphoma: Clinicopathological Profile.

IntroductionGastrointestinal tract (GIT) is the most common site of involvement of extranodal non-Hodgkin’s lymphoma (NHL). There is regional variation in anatomical distribution of extranodal NHL, stomach being the most common site followed by small intestine. Primary gastric lymphoma (PGL) predominantly involves the antrum and corpus of the stomach. It arises from mucosa-associated lymphoid tissue (MALT) and is of B-cell lineage and often associated with Helicobacter pylori infection. Primary gastric lymphoma often presents with nonspecific symptoms. The present study was undertaken to ascertain the clinicopathological characteristics of PGL at a tertiary care center in South India.Materials and methodsIt is a retrospective study from 2006 to 2016. Patient’s data were obtained from institutional medical records. The histopathology slides were reviewed. The relevant immunohistochemistry (IHC) markers done were leukocyte common antigen (LCA), CD3, CD20, CD79a, CD10, Bcl-2, Bcl-6, CD5, Cyclin D1, CD138, and Ki-67. Correlating with the immunoprofile, further subtyping was done.ResultsA total of 405 patients of NHL were seen during the study period, out of which 43 patients were PGL. There were 32 males and 11 females, with M:F of 2.9:1. The mean age at diagnosis was 58 years. Abdominal pain and new-onset dyspepsia were the commonly observed presenting symptoms. The common site of involvement was antrum (20). Diffuse large B-cell lymphoma (DLBCL) was the most common histological subtype. Helicobacter pylori infection was seen in 18 (41%) patients. Majority of the patients were in stages II and III.ConclusionIn our study, the initial presentation of PGL was with nonspecific symptoms like abdominal pain and new-onset dyspepsia. High degree of suspicion of such symptoms and biopsy of all suspicious lesions is essential for early detection. Diffuse large B-cell lymphoma was the most common histological subtype seen in our study.How to cite this article: Malipatel R, Patil M, Rout P, Correa M, Devarbhavi H. Primary Gastric Lymphoma: Clinicopathological Profile. Euroasian J Hepato-Gastroenterol 2018;8(1):6-10.

Sa1261 DIFFERENCES IN ENDOSCOPIC FINDINGS BETWEEN PRIMARY AND SECONDARY GASTRIC LYMPHOMA

Gastric lymphoma occupies about 5% of gastric malignancy and diffuse large B cell lymphoma (DLBCL) is most common type of primary gastric lymphoma. Since endoscopic findings of gastric lymphoma are ambiguous and diverse, it is not easy to distinguish from gastric adenocarcinoma. Moreover, it is more difficult to distinguish between primary gastric lymphoma and gastric involvement of lymphoma. The aim of this study was to investigate the clinical and endoscopic features and differences of primary gastric lymphoma and gastric involvement of lymphoma. Forty-eight patients were enrolled in this retrospective study between June 2008 and February 2017. These enrolled patients were divided into primary gastric lymphoma group (primary group, n=18) and gastric involvement group (secondary group, n=30) based on whether or not they had only gastric lesion. Patient’s clinical characteristics, endoscopic findings and pathologic data were retrospectively reviewed by using electronic medical record. The mean age of the whole patients was 63.31±13.12 years and twenty-nine patients were female (60.4%). When considering all patients, DLBCL on pathology (81.3%), gastric body involvement on location (47.9%) and ulceroinfitrative morphologic type on endoscopy (43.8%) were more common features. Regardless of the two groups, only about 41.7% of the initial endoscopic diagnosis considered lymphoma. Compared to primary group, regional lymph node involvement (p<0.001) and bone marrow involvement (p=0.072) were more associated with secondary group. However, there was no significant findings on endoscopic features including location, size, number and morphology of lesion. Endoscopically diagnosis of gastric lymphoma is not easy, even when confirmed separately for the primary and secondary groups, there is no endoscopic difference. Therefore, in order to diagnose the gastric lymphoma, aggressive tissue examination is important.

Primary Gastric Lymphoma, Epidemiology, Clinical Diagnosis, and Treatment.

Primary gastric lymphoma (PGL) is the most common extranodal non-Hodgkin lymphoma and represents a wide spectrum of disease, ranging from indolent low-grade marginal zone lymphoma or mucosa-associated lymphoid tissue (MALT) lymphoma to aggressive diffuse large B-cell lymphoma. The PGL is a relatively rare cancer and easily misdiagnosed due to its unspecific symptoms of the digestive tract. The medical literature and ongoing clinical trials were reviewed on the clinical presentation, diagnosis, prognosis, prevention, and treatment of PGL. Primary gastric lymphoma is an event in the course of cancer with a variable clinical presentation and a wide differential diagnosis. Chronic gastritis secondary to Helicobacter pylori (H pylori) infection has been considered a major predisposing factor for MALT lymphoma. Magnetic resonance imaging and endoscopic ultrasonography have helped in staging of these cancers. The clinical course and prognosis of this disease are dependent on histopathological subtype and stage at the time of diagnosis. A global therapeutic approach to the cure of PGL has completely changed over the past 10 years, including innovative and conservative options to reduce treatment toxicity. Due to the rarity of PGL, many aspects of this neoplasm are still controversial. The incidence of this disease is increasing, making it necessary for clinicians to understand the clinical symptoms, workup, and treatment of these lymphomas.

MALT lymphoma: epidemiology, clinical diagnosis and treatment.

Primary gastric lymphoma (PGL) represents a rare pathology, which can be easily misdiagnosed because of unspecific symptoms of the digestive tract. Histologically, PGL can vary from indolent marginal zone B-cell lymphoma of the mucosa-associated lymphoid tissue (MALT) to aggressive diffuse large B-cell lymphoma (DLBCL). During the years, clinical trials revealed the important role of Helicobacter pylori (H. pylori) in the pathogenesis of gastric MALT lymphoma. Infection with Helicobacter pylori is an influential promoter of gastric lymphomagenesis initiation. Long-term studies revealed that eradication therapy could regress gastric lymphomas.

The importance of Helicobacter pylori in the development of gastric MALT lymphoma — induction of proliferation and immune suppression

Marginal zone B-cell lymphomas are indolent, slow-growing lymphomas derived from mature B cells. They represent about 8% of all lymphomas and about 50% of all primary gastric lymphomas. Based on numerous epidemiological and microbiological studies, Helicobacter pylori is believed to be responsible for the progression of gastric MALT lymphomas (GML). Lymphoid tissue is physiologically absent from the stomach. However, GML can arise from chronic H. pylori infection and immune cell infiltration. This review article describes the mechanisms favouring the development of H. pylori -induced GML, and suggests potential targets for a more effective remission of lymphomas localized within the stomach.

Paediatric Helicobacter Pylori Infection in Taiwan: Current Status and Perspectives

Helicobacter pylori infection is the most prevalent chronic bacterial infection in the world. The prevalence of H. pylori infection ranges from approximately 10–90% and is influenced by age, country, socioeconomic status, nutritional status, urbanisation, hygiene, and diagnostic tools available. In general, chronic H. pylori infection can lead to chronic antral gastritis, peptic ulcer disease, primary gastric lymphoma, and gastric adenocarcinoma. As public hygiene and sanitation have improved, the rates of H. pylori infection and related diseases have been declining annually in developed and rapidly developing countries, although the infection is still common in some geographic areas. In Taiwan, an Asian country with a high incidence rate of gastric malignancy, there is a similar trend of declining H. pylori prevalence rates. Prevalence rate differed vastly between rural and urban areas; however, rates have fallen greatly in recent decades. Optimal treatment of H. pylori infection in children has not yet been determined and will require further collaborative studies. However, eradication failures are concerning since global rates of antibiotic resistance are increasing and therapy for H. pylori infection is increasingly prescribed. In Taiwan, the overall antimicrobial resistant rates to clarithromycin, metronidazole, and levofloxacin were 23.4%, 20.3%, and 11.8%, respectively. With the propagation of public health education, advancement of diagnostic tools, and patient-specific tailoring of therapeutic strategies, the prevalence and eradication failure rate of H. pylori infection in children should improve in the near future, both in developed and developing countries.

Treatment of primary gastric lymphoma

Stomach is the most common location of lymphoma in digestive tract, accounting for 50%-60% of gastrointestinal lymphomas. The most common histological types are low malignant mucosa-associated lymphoid tissue (MALT) lymphoma from non-Hodgkin lymphoma (NHL) and diffuse large B-cell and marginal zone B-cell lymphoma (DLBCL) from NHL. Chronic gastritis secondary to Helicobacter pylori(HP) infection has been considered a major predisposing factor for MALT lymphoma. At present, the most widely accepted initial therapy for localized disease is aimed at the eradication of HP using regimens combining antibiotics and proton-pump inhibitors. The irradiation has become the therapy of choice for patients with early stage MALT lymphoma without HP infection or with persistent lymphoma following antibiotic therapy. In all the patients with advanced disease, treatment options include chemotherapy and the use of monoclonal antibodies. Treatment of DLBCL in stomach is based on aggressive poly-chemotherapy that is usually combined with rituximab. The same guidelines followed for nodal aggressive lymphoma can also be applied to gastric lymphoma with aggressive histology as DLBCL. For localized stages (stages I( and II(), these guidelines suggest front-line therapy with 3 to 4 cycles of standard R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone) followed by radiotherapy. Advanced stage patients (stage IIII() usually undergo only 6 to 8 cycles of R-CHOP in order to obtain a complete remission rate. Nowadays surgery is limited to rare cases and radiotherapy combined or not with chemotherapy represents an effective therapeutic option ensuring long-term, organ-salvage benefits mainly in aggressive histological types.

Clinical manifestations and epigenetic mechanisms of gastric mucosa associated lymphoid tissue lymphoma and long-term follow-up following Helicobacter pylori eradication.

The current study aimed to summarize the clinical manifestations and identify the epigenetic mechanisms of gastric mucosa associated lymphoid tissue (MALT) lymphoma, as well as evaluate the long-term effects of Helicobacter pylori (H. pylori) eradication. A total of 122 patients with marginal zone B-cell lymphoma of primary gastric MALT lymphoma were enrolled in the present study. The clinical manifestations of gastric MALT lymphoma, including symptoms, H. pylori state and endoscopic type, were summarized. The response to therapy was evaluated in patients that underwent H. pylori eradication. Survival analysis was estimated using the Kaplan-Meier method. The expression of microRNA-383 (miR-383) in tumor tissues and cell lines was determined using reverse transcription quantitative polymerase chain reaction. Furthermore, bioinformatic analyses, luciferase reporter assays. and western blot analysis identified zinc finger E-box binding homeobox 2 (ZEB2) as a direct target gene of miR-383. An MTT assay was used to examine the function of miR-383 and ZEB2 in MALT lymphoma. The clinical symptoms of patients with gastric MALT lymphoma were non-specific and included epigastric pain, abdominal discomfort and bleeding. The majority of endoscopic types were classified as ulcer, erosion and mucosa edema. The H. pylori infection rate was 79.5% (97/122) and a total of 47 patients underwent eradication therapy. Lymphoma remission was achieved in 93.6% (44/47) of patients and complete remission (CR) was achieved in 74.4% (35/47). The median follow-up time was 38 months (range, 10-132 months) and the median time taken to achieve CR was 4 months (range, 3-7 months). The estimated 3-year survival rate was 90.3% and the 5-year survival rate was 76.2%. Therefore, it was determined that patients with stage I or II gastric MALT lymphoma are able to undergo H. pylori eradication as a first-line treatment and that the survival rate of patients undergoing this treatment is high. Furthermore, it was determined that the mechanism by which miR-383 and ZEB2 contribute to MALT lymphoma progression is by the targeting of ZEB2 by miR-383, which inhibits the proliferation of cancer cells.