Helicobacter pylori in primary gastric lymphoma and gastric cancer: A clinicopathologic and prognostic assessment

Yıl 2013, Cilt: 3 Sayı: 02, 61 - 66, 01.06.2013

Mehmet Kucukoner Ozan Balakan Muhammed Ali Kaplan Ali Inal Zuhat Urakci Ulas Alabalik Sinan Dal Yilmaz Yildiz Abdurrahman Isikdogan

https://doi.org/10.5799/ahinjs.02.2013.02.0082

Öz

Objectives: Helicobacter pylori infection is a risk factor for gastric adenocarcinoma and primary gastric lymphoma. We examined whether this H.pylori infection is also a prognostic factor for gastric cancer and primary gastric lymphoma. Methods: Resected or biopsied specimens from 255 patients with gastric adenocarcinoma and primary gastric lym&shy;phoma were investigated for H.pylori status. Hematoxylin and eosin stain was used to evaluate the presence or absence of H.pylori on formalin fixed, paraffin embedded specimens. Results: H.pylori were detected in 34 of 140 patients (24.3%) with primary gastric lymphoma, while H.pylori were de&shy;tected in 62 of 115 patients (53.9%) with gastric cancer. The frequency of H.pylori positivity was higher in patients with gastric cancer than in those with gastric lymphoma (p<0.001). The frequency of H.pylori positivity was different between mucosa-associated lymphoid tissue type (MALT) lymphomas (53.5%) and lymphomas other than diffuse large b-cell lymphoma (DLBCL) (18.7%) in gastric lymphoma (p<0.001). For patients with primary gastric lymphoma, H.pylori status did not correlate with the disease free survival and overall survival (p=0.833, p= 0.503). However for patients with gastric cancer, H.pylori status did not correlate with the disease- free survival and overall survival (p=0.392, p= 0.357). Conclusions: In our study, between gastric cancer and primary gastric lymphoma were significant differences in terms of the presence of H.pylori. However, H.pylori did not have prognostic significance on survival for both pairs.

Anahtar Kelimeler

H.pylori

Helicobacter pylori in primary gastric lymphoma and gastric cancer: A clinicopathologic and prognostic assessment

Öz

Amaç: Helicobacter pylori mide lenfoması ve adenokarsinom için risk faktörüdür. Bu çalışmada H. pylori’nin primer mide lenfoma ve mide kanserinde prognostik faktör olup olmadığı incelendi.Yöntemler: Primer mide lenfoma ve mide kanserli 255 hastanın rezeksiyon veya biyopsi materyalleri H. pylori açısından incelendi. Patoloji spesmenlerinde H. pylori varlığını değerlendirmek için hematoksilen ve eozin boyası kullanıldı.Bulgular: Primer mide lenfomalı 140 hastanın 34’ünde (%24,3) H. pylori saptanırken mide kanserli 115 hastanın 62’sinde (%53,9) H. pylori saptandı. H. pylori varlığı mide kanserli hastalarda, mide lenfomalardan daha sık görüldü (p<0.001). H. pylori pozitifliği, mide lenfoma içinde mukoza ilişkili lenfoid doku tip lenfomada (MALT) %53,5 oranında, diffüz büyük B hücreli lenfomadan farklı olarak %18,7 oranında görüldü (p<0,001). Primer mide lenfoma da H. pylori’nin varlığı hastalıksız sağkalım ve genel sağkalım açısından anlamlılık oluşturmuyordu (p=0,833, p= 0,503). Bununla beraber mide kanserli hastalarda da H. pylori varlığı ile hastalıksız sağkalım ve genel sağkalımda da anlamlılık oluşturmuyordu (p=0,392, p= 0,357). Sonuç: Çalışmamızda mide kanserli ve primer mide lenfoma arasında H. pylori varlığı bakımından anlamlı farklılık vardı. Ancak H. pylori varlığı, hem hastalıksız sağkalım hem de genel sağkalım açısından prognostik anlamlılık oluşturmuyordu

Anahtar Kelimeler

H. pylori, Primer mide lenfoma, Mide kanser

Kaynakça

• Parsonnet J, Friedman GD, Vandersteen DP, et al. Helico- bacter pylori infection and the risk of gastric carcinoma. N Engl J Med 1991;325:1127-1131.
• Wotherspoon AC, Ortiz-Hidalgo C, Falzon MR, Isaacson PG. Helicobacter pylori associated gastritis and primary B-cell g astric lymphoma. Lancet 1991;338:1175-1176.
• Parsonnet J, Hansen S, Rodriguez L, et al. Helicobacter pylori infection and gastric lymphoma. N Engl J Med 1994;330:1267-1271.
• International Agency for Research on Cancer (IARC). Schisto- somes, liver flukes, and Helicobacter pylori. In: IARC Mono- graphs on the evaluation of carcinogenic risks to humans, France. Lyon. 1994;2061.
• Weber DM, Dimopoulos MA, Anandu DP, Pugh WC, Steinbach G. Regression of gastric lymphoma of mucosa-associated lymphoid tissue with antibiotic therapy for Helicobacter py- lori. Gastroenterology 1994;107:1835-1838.
• Graham DY, Shiotani A. The time to eradicate gastric cancer is now. Gut 2005;54:735-738.
• Malfertheiner P, Sipponen P, Naumann M, et al. Helico- bacter pylori eradication has the potential to prevent gas- tric cancer: a state-of-the-art-critique. Am J Gastroenterol 2005;100:2100-2115.
• Ferrucci PF, Zucca E. Primary gastric lymphoma pathogenesis and treatment: what has changed over the past 10 years? British Journal of Haematology 2006;136:521-538.
• Santacroce L, Cagiano R, Del Prete R, et al. Helicobacter pylori infection and gastric MALTomas: an up-to-date and therapy highlight. La Clinica terapeutica 2008;159:457-462.
• Parkin DM, Bray F, Ferlay J, Pisani P. Global cancer statis- tics, 2002. CA Cancer J Clin 2005;55:74-108.
• Lauren P. The two histological main types of gastric carci- noma: diffused and so-called intestinal-type carcinoma. An attempt at a histo-clinical classification. Acta Pathol Microbiol Scand 1965;64:31-49.
• Honda S, Fujioka T, Tokieda M, Satoh R, Nishizono A, Nasu M. Development of Helicobacter pylori-induced gastric carci- noma in Mongolian gerbils. Cancer Res 1998; 58:4255-4259.
• Gray SF, Wyatt JI, Rathbone BJ. Simplified techniques for identifying Campylobacter pyloridis. J Clin Pathol 1986;39:1279-1280.
• Isaacson PG. Gastrointestinal lymphoma. Hum Pathol 1994;25:1020-1029.
• Rohatiner A, d’Amore F, Coiffier B, et al. Report on a work- shop convened to discuss the pathological and staging clas- sifications of gastrointestinal tract lymphoma. Ann Oncol 1994;5:397-400.
• Stephen B. Edge, Carolyn C. Compton. The American Joint Committee on Cancer: the 7th Edition of the AJCC Cancer Staging Manual and the Future of TNM. Ann Surg Oncol 2010;17:1471-1474.
• Bhandari A, Crowe SE. Curr Gastroenterol Rep 2012;14:489- 96.
• Eidt S, Stolte M, Fischer R. Helicobacter pylori gastritis and primary gastric non-Hodgkin’s lymphomas. J Clin Pathol 1994;47:436-439.
• Forman D, Newell DG, Fullerton F, et al. Association be- tween infection with Helicobacter pylori and risk of gastric cancer: evidence from prospective investigation. Br Med J 1991;302:1302-1305.
• Bayerdörffer E, Neubauer A, Rudolph B, et al. Regression of primary gastric lymphoma of mucosa-associated lymphoid tissue type after cure of Helicobacter pylori infection. Lancet 1995; 345:1591-1594.
• Roggero E, Zucca E, Pinotti G, et al. Eradication of He- licobacter pylori infection in primary gastric lymphoma of mucosa-associated lymphoid tissue. Ann Intern Med 1995;122:767-769.
• Kucukoner M, Arpaci E, Isikdogan A, et al. Prognostic Analy- sis of Patients with Operable Gastric Cancer and Toler- ability to Adjuvant Radio-Chemo-Therapy. Neoplasma, doi: 10.4149/neo_2013_003.
• Bor S, Vardar R, Ormeci N, et al. Prevalence patterns of gas- tric cancers in Turkey: Model of a developing country with high occurrence of Helicobacter pylori. J Gastroenterol Hep- atol 2007; 22: 2242-45.
• Ekstrom AM, Held M, Hansson LE, Engstrand L, Nyren O. Helicobacter pylori in gastric cancer established by CagA immunoblot as a marker of past infection. Gastroenterology 2001;121:784-791.
• Amer H. Zureikat, Matthew T. Heller, Herbert JZ. Cancer of the Small Intestine. In Devita VT, Lawrence T, and Rosen- berg SA (eds): Cancer: Principles and Practise of Oncol- ogy. 9th edition. Philadelphia Lippincott Williams & Wilkins 2011;P.1055-1056.
• Kamangar F, Dores GM, Anderson WF. Patterns of cancer incidence, mortality, and prevalence across five continents: defining priorities to reduce cancer disparities in different geographic regions of the world. J Clin Oncol 2006;24:2137- 2150.
• Hoon Hur, Sang Rim Lee, Yi Xuan, et al. The Effects of He- licobacter pylori on the prognosis of patients with curatively resected gastric cancers in a population with high infection rate. J Korean Surg Soc 2012;83:203-211.
• Marrelli D, Pedrazzani C, Berardi A, et al. Negative Helico- bacter pylori status is associated with poor prognosis in pa- tients with gastric cancer. Cancer 2009;115:2071-2080.
• Meimarakis G, Winter H, Assmann I, et al. Helicobacter pylori as a prognostic indicator after curative resection of gastric car- cinoma: a prospective study. Lancet Oncol 2006;7:211-222.