Helikobakter pilori enfeksiyonu Mikozis fungoides için risk faktörü müdür?

Year 2013, Volume: 23 Issue: 3, 77 - 80, 01.01.2013

Munise Daye İnci Mevlitoğlu Kemal Tahir Şahin Hanife Merve Akça

Abstract

Giriş: Kutane T hücreli lenfomalar KTHL ’ın iki önemli varyantı; Mikozis fungoides ve Sezary sendromudur. KTHL’ın oluşumun- daki, otolog dendiritik hücrelerin, tümöral yöndeki dönüşümlerini, hangi antijenlerin başlattığı bilinmemektedir. Helicobacter py- lori’nin H.pylori bazı dermatozlarla ilişkili olduğu bilinmektedir. H.pylori; kronik gastrit, peptik ülser ve gastrik mukoza ilişkili lenfoid doku lenfomanın MALT gastrik B hücreli lenfoması ile kuvvetle ilişkili gram - bakteridir. Bu çalışmada H.pylori enfeksi- yonu ile MF gelişimi arasındaki ilişkiyi değerlendirmeyi amaçladık. Gereç ve yöntem: Bu çalışma yaş-cinsiyet eşlemeli vaka-kontrol çalışmasıdır. MF’i olan 50 olgunun 37 %74 ’si evre1 n=13 %26 evre1A n=24 %48 evre 1B , 13 %26 ’ü evre 2A’ıydı. H.pylori enfeksiyonu ile ilişkisiz dermatolojik hastalığı bulunan 50 olgu kontrol olguları olarak alındı. H.pylori için H. pylori gayta antijen tes- tiyle bakıldı. Bulgular: MF olgularının ortanca yaşı 48 38.75-59.25 , kontrol olgularının ortanca yaşı 53 yıldı. MF olgularının ortalama hastalık süresi 7 yıldı. MF ve kontrol olgularının yaş ve cinsiyet açısından aralarında fark saptanmadı. MF olguları- nın 12 %24 ’sinde H.pylori gayta antijen test + idi. Cinsiyet p=0.185 , evre p=0.1570 , hastalık süresi p=0.846 ile H.pylori + ‘liği arasında fark saptanmadı. MF ve kontrol olgularının H.pylori gayta antijen + ’liği arasında fark saptanmadı p=0.648 . Sonuç: Çalışmamızda H.pylori enfeksiyonu ile MF arasında ilişki saptanmadı. Farklı toplumlarda prospektif, multimerkez çalışmaların ya- pılmasının faydalı olacağını, H.pylori antijeninin MF olgularının MF lezyonu olan dokusunda bakılmasının olası ilişkiyi araştırmada yardımcı olabileceğini düşünmekteyiz

Keywords

Helicobacter pylori, Mikozis fungoides, lenfoma

Is Helicobacter pylori infection a risk factor for Mycosis fungoides ?

Abstract

Objectives: The most common forms of Cutaneous T-cell lymphomas CTCL are Mycosis fungoides MF and Sezary Syndrome SS . Etiology of triggering antigenic stimulation causes to form clonal T cell proliferation is not clear. Helicobacter pylori H.pylori known to be associated some dermatologic disorders. H.pylori causes primary gastric B cell lymphoma of MALT-type by chronic antigenic stimulation forming clonal proliferation. We evaluated the relationship between H. pylori infection and the development of MF. Materials and methods: This is a sex-age matched case-control study. We studied 50 MF patient, 37 %74 patient were stage 1 n=13 %26 stage 1A n=24 %48 stage 1B , 13 %26 patient were stage 2A. 50 controls have other dermatologic disorders without any relation between H. pylori infection and their dermatologic disorder. H.pylori infection detected with H. pylori stool antigen. Results: Median age for MF patients were 48 38.75-59.25 . Median age for controls were 53 . Mean MF disease duration was 7 year. There is no difference between ages and sex of MF and controls. 12 %24 of MF patient have + results for H.pylori stool antigen. There is no difference for H. pylori + results with sex p=0.185 , stage p=0.1570 and disease duration p=0.846 . MF and control patients have no difference for H. pylori stool antigen + results p=0.648 . Conclusion: Our study did not confirm the relationship between H.pylori infection and MF. We suggest that investigators should plan prospective multicenter studies in different populations. Investigation for antigenic stimulation of H.pylori antigen may be looked in MF tissues

Keywords

Helicobacter pylori, Mycosis fungoides, lymphoma

References

• Mirvish ED, Pomerantz RG, Geskin LJ. Infectious agents in cutane- ous T-cell lymphoma. J Am Acad Dermatol 2011;64:423-31.
• Wilcox RA. Cutaneous T-Cell Lymphoma: 2011 update on di- agnosis, risk-stratification, and management. Am J Hematol 2011;86:929-48.
• Berger CL, Hanlon D, Kanada D, et al. The growth of cutaneous T-cell lymphoma is stimulated by immature dendritic cells. Blood 2002;99:2929-39.
• Yepes S, Torres MM, Saavedra C, Andrade R. Gastric mucosa-asso- ciated lymphoid tissue lymphomas and Helicobacter pylori infecti- on: A Colombian perspective. World J Gastroenterol 2012;18:685- 91.
• Aktepe OC, Ciftci IH, Safak B, et al. Five methods for detection of Helicobacter pylori in the Turkish population. World J Gastroen- terol 2011;17:5172-6.
• Bonin S, Tothova SM, Barbazza R, et al. Evidence of multiple in- fectious agents in mycosis fungoides lesions. Exp Mol Pathol 2010;89:46-50.
• Aydın F, Şentürk N, Cantürk T, Turanlı AY. Helicobacter pylori and skin: Review. Turkderm 2004;38:102-5.
• Shimakage M, Sasagawa T, Kawahara K, et al. Expression of Eps- tein-Barr virus in cutaneous T-cell lymphoma including mycosis fungoides. Int J Cancer 2001;92:226-31.
• Kanegane H, Nomura K, Miyawaki T, et al. Biological aspects of Epstein-Barr virus (EBV)-infected lymphocytes in chronic active EBV infection and associated malignancies. Crit Rev Oncol Hema- tol 2002;44:239-49.
• Herne KL, Talpur R, Breuer-McHam J, et al. Cytomegalovirus se- ropositivity is significantly associated with mycosis fungoides and Sezary syndrome. Blood 2003;101:2132-6.
• Diamandidou E, Cohen PR, Kurzrock R. Mycosis fungoides and Sezary syndrome. Blood 1996;88:2385-409.
• Tocura Y, Heald PW, Yan SL, Edelson RL. Stimulation of cutaneous T- cell lymphoma cell with superantigenic staphylococcal toxins. J Invest Dermatol 1992;98:33-7.
• Latkowski JA, Heald P. Cutaneous T Cell Lymphomas. In: Fitzpat- rick’s Dermatology in General ( Freedberg IM, Eisen AZ, Wolff K, eds) 6th edn. New York: McGraw-Hill Ltd., 2003: 1537-58.
• Abrams J.T, Bahn BJ, Vonderheid EC. Association between Sezary T cell-activating factor, Chlamydia pneumoniae, and cutaneous T cell lymphoma. Ann N Y Acad Sei 2001;941:69-85.
• Jackow CM, Cather JC, Hearne V, et al. Association of erythroder- mic cutaneous T-cell lymphoma, superantigen-positive Staphylo- coccus aureus, and oligoclonal T-cell receptor V beta gene expansi- on. Blood 1997;89:32-40.
• Tothova SM, Bonin S, Trevisan G, et al. Mycosis fungoides: is it a Borrelia burgdorferi-associated disease? Br J Cancer 2006;94:879- 83.
• Malfertheiner P, Megraud F, O’Morain C, et al. Current concepts in the management of Helicobacter pylori infection--the Maastricht 2-2000 Consensus Report. Aliment Pharmacol Ther 2002;16:167- 80.
• Manes G, Balzano A, Iaquinto G, et al. Accuracy of the stool anti- gen test in the diagnosis of Helicobacter pylori infection before tre- atment and in patients on omeprazole therapy. Aliment Pharmacol Ther 2001;15:73-9.
• Braden B. Diagnosis of Helicobacter pylori infection. BMJ 2012;344:e828.
• Gisbert JP, Pajares JM. Stool Antigen test for the diagnosis of helicobacter pylori ınfection: a systematic review. Helicobacter 2004;9:347-68.
• Morgner A, Bayerdorffer E, Neubauer A, et al. Malignant tumors of the stomach. Gastric mucosa-associated lymphoid tissue lym- phoma and Helicobacter pylori. Gastroenterol Clin North Am 2000;29:593-607.
• D’Elios MM, Amedei A, Del Prete G. Helicobacter pylori anti- gen-specific T-cell responses at gastric level in chronic gastritis, peptic ulcer, gastric cancer and low-grade mucosa-associated ly- mphoid tissue (MALT) lymphoma. Microbes Infect 2003;5:723-30.
• Boot H, de Jong D. Gastric lymphoma: the revolution of the past decade. Scand J Gastroenterol 2002;236:27-36.
• Luppi M, Longo G, Ferrari MG, et al. Additional neoplasms and HCV infection in low-grade lymphoma of MALT type. Br J Hae- matol 1996;94:373-5.
• Ohmatsu H, Saeki H, Fujita H, et al. Mycosis fungoides associated with intestinal mucosa-associated lymphoid tissue lymphoma. Int J Dermatol 2005;44:878-80.