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Review
. 2013 Dec 7;19(45):8181-7.
doi: 10.3748/wjg.v19.i45.8181.

Helicobacter pylori and gastric mucosa-associated lymphoid tissue lymphoma: recent progress in pathogenesis and management

Shotaro Nakamura  1 , Takayuki Matsumoto  1
Affiliations
Review

Helicobacter pylori and gastric mucosa-associated lymphoid tissue lymphoma: recent progress in pathogenesis and management

Shotaro Nakamura et al. World J Gastroenterol. .

Abstract

Recent progress in the research regarding the molecular pathogenesis and management of gastric mucosa-associated lymphoid tissue (MALT) lymphoma is reviewed. In approximately 90% of cases, Helicobacter pylori (H. pylori) infection plays the causative role in the pathogenesis, and H. pylori eradication is nowadays the first-line treatment for this disease, which leads to complete disease remission in 50%-90% of cases. In H. pylori-dependent cases, microbe-generated immune responses, including interaction between B and T cells involving CD40 and CD40L co-stimulatory molecules, are considered to induce the development of MALT lymphoma. In H. pylori-independent cases, activation of the nuclear factor-κB pathway by oncogenic products of specific chromosomal translocations such as t(11;18)/API2-MALT1, or inactivation of tumor necrosis factor alpha-induced protein 3 (A20) are considered to contribute to the lymphomagenesis. Recently, a large-scale Japanese multicenter study confirmed that the long-term clinical outcome of gastric MALT lymphoma after H. pylori eradication is excellent. Treatment modalities for patients not responding to H. pylori eradication include a "watch and wait" strategy, radiotherapy, chemotherapy, rituximab immunotherapy, and a combination of these. Because of the indolent behavior of MALT lymphoma, second-line treatment should be tailored in consideration of the clinical stage and extent of the disease in each patient.

Keywords: Gastric lymphoma; Helicobacter pylori; Mucosa-associated lymphoid tissue lymphoma; Nuclear factor κB.

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Figures

Figure 1
Figure 1
Endoscopic images of gastric mucosa-associated lymphoid tissue lymphoma, superficial type. A, B: Pretreatment images; a superficially depressed lesion with multiple erosions and small ulcers with reddish granular mucosa can be seen on the posterior wall of the angularis; C: Follow-up image 6 mo after H. pylori eradication showing regression of the initial lesion.
See this image and copyright information in PMC

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