ABSTRACT
Objective: A single-center retrospective analysis was performed to obtain data on the clinical characteristics and the factors influencing the survival of patients with mucosa associated lymphoma tissue lymphoma (MALT lymphoma). Method: From September 2012 to May 2019, we retrospectively analyzed 180 cases of MALT lymphoma diagnosed through pathological biopsy. Result: Among the 180 patients, 99 (55.0%) were male and 81 (45.0%) were female. The age at onset was 31-84 years, and the median age was 57 years. There were 59 (32.8%), 66 (96.1%), and 55 (3.9%) cases involving gastrointestinal, ocular, and other extranodal primary sites, which included the lung, pharyngeal lymph ring, thyroid, parotid gland, and testis, respectively. Moreover, there were 173 (94.4%) cases of clinical stage -Ⅱdisease and 7 cases (5.6%) of clinical stage III- disease. The 5-year overall survival (OS) rates in the gastrointestinal, ocular, and other groups were 96.7%, 95.5%, and 86.4%, respectively, and the difference was not statistically significant (P= 0.118). The 5-year progression-free survival (PFS) rates were 82.4%, 86.6%, and 86.4% in the corresponding groups, respectively, and the difference was not statistically significant (P=0.862). The single-factor correlation analysis of prognosis indicated that low hemoglobin (P=0.006) and high β2-microglobulin (P=0.013) levels were related to OS, while an increase in β2-microglobulin (β2-MG) (P=0.004) levels was related to OS and PFS. Survival analysis showed that a low hemoglobin level was significantly associated with OS (P=0.015). Conclusions: MALT lymphoma can originate from different parts of the body. Additionally, the patients show slow clinical progress, late recurrence, and long total survival. Low hemoglobin and β2-MG levels can be used as important indexes for clinical prognosis.
ABSTRACT
Introducción: La asociación entre Helicobacter pylori y las neoplasias gástricas malignas ha sido ampliamente demostrada, en relación con esto, la OMS determinó que el microorganismo es agente carcinógeno comprobado del grupo I. En México la prevalencia de infección por esta bacteria es alta. Objetivo: Evaluación de la relación entre variables sociodemográficas, clínicoendoscópicas e histopatológicas con los diferentes tipos de neoplasias gástricas malignas en pacientes Helicobacter pylori positivos y negativos. Pacientes y métodos: Se desarrolló una investigación en la región Sur de México, de tipo retrospectiva, descriptiva e inferencial; se estudiaron 214 casos con adenocarcinoma gástrico y linfoma asociado a mucosas (MALT, por sus siglas en inglés), diagnosticados en el período 2001-2011, de los cuales 99 presentaron Helicobacter pylori. Se utilizaron técnicas estadísticas para evaluar la posible relación entre variables. Procedimientos: Media aritmética y desviación estándar, porcentajes y sus errores. Técnicas: Prueba de Chi² para tablas de contingencia, correlación de rango de Spearman, estimación de parámetros poblacionales, comparación de porcentajes relacionados. Resultados: Se encontraron asociaciones significativas entre el diagnóstico histológico y edades, serotipo sanguíneo, antecedente de familiares con cáncer y la sintomatología (dispepsia y signos de alarma). Y asociaciones muy significativas entre la presencia de Helicobacter pylori con vivos, fallecidos y el diagnóstico histológico. Se determinó que el adenocarcinoma difuso aparece entre 48,8% y 62,4% con una probabilidad de 95% en la población con esta característica, igualmente el porcentaje de neoplasia/tumor dentro del diagnóstico endoscópico oscila entre 68,4% y 80,6% con una probabilidad de 95%. El intervalo de confianza con 99% de certeza para la edad en que se manifiestan estas enfermedades se mueve entre 56 y 62 años. Conclusiones: Queda demostrado que las características sociodemográficas, clínicoendoscópicas e histológicas de los pacientes con adenocarcinoma y linfoma MALT influyen en el diagnóstico final, evolución y pronóstico. La presencia de Helicobacter pylori en estos pacientes fue determinante para su sobrevivencia.
Introduction:The association between Helicobacter pylori and the gastric malignant has been extensively demonstrated, in relation to this, the WHO determined that the microorganism is a carcinogen agent proved from group I. In Mexico the prevalence of infection by this bacterium it is high Objective: Evaluation of the relationship between the socio-demographic, clinical-endoscopic and histopathological variables with the different kinds of gastric malignant in Helicobacter pylori positive and negative patients. Patients and methods: An investigation was carried out to determine the kind of association in a population of the south region of Mexico. The type of research is retrospective, descriptive and inferential, 214 cases with gastric adenocarcinoma and lymphoma associated to the mucosal (MALT) were studied, they were diagnosed from 2001 to 2011, of which 99 had Helicobacter pylori. Statistical techniques to evaluate the possible relationship between variables were used. Procedures: Arithmetic mean and standard deviation, percentages and its errors. Techniques: Chi square test for contingency tables, correlation of Spearman´s range, population parameter estimation, related percentage comparison. Results: It was found meaningful associations between the histologic diagnostic and ages, blood serotype, antecedent of relatives with cancer and the symptomatology (dyspepsia and alarm signs), and very meaningful association between the presence of Helicobacter pylori with alive, deceased and the histologic diagnostic. It was determined that diffuse adenocarcinoma appears between a 48,8% and 62,4% with a probability of the 95% in the population with this characteristics, likewise, the percentage of neoplasm/toumor within endoscopic diagnosis ranges between 68,4% and 80,6% with a 95% probability. The interval of confidence with the 99% of certainty for the age in which these illnesses appear it moves between 56 and 62 years. Conclusions: It has been proved that the socio-demographic, clinical-endoscopic and histologic characteristics of these patients with adenocarcinoma and lymphoma MALT have an influence in the final diagnostic, evolution and prognostic. The presence of Helicobacter pylori in these patients was determining for their survival.
ABSTRACT
Helicobacter pylori es una bacteria con forma helicoidal, que vive únicamente en el estómago humano. Aunque la relación del bacilo con el epitelio es de antaño debido a que gran parte de la población se halla colonizada, tan solo cerca del 10% de las personas infectadas desarrollan ciertas patologías, entre ellas la úlcera duodenal, el adenocarcinoma estomacal y el linfoma tipo MALT. En las últimas décadas, la investigación sobre el Helicobacter pylori se ha incrementado, y poco a poco, se ha deslumbrando más sobre la fi siopatología de este microorganismo, como la presencia de genes involucrados en la patogenicidad vacA, cagA babA y sabA, indicando con ello que no es precisamente una bacteria totalmente inocua, pero tampoco el del mayor patógeno en el epitelio estomacal. Mediante la presente revisión se pretende abarcar algunos aspectos sobre la bacteria, su relación y benefi cios con el huésped, así como los procesos patológicos que puede desencadenar su accionar.
Helicobacter pylori is a spiral-shaped bacterium, that lives only in the human stomach. Although the relationship of the bacillus in the epithelium has been since ancient because most of the population is colonized, only about 10% of infected people develop certain diseases, including duodenal ulcer, stomach adenocarcinoma and lymphoma MALT. In recent decades, research on Helicobacter pylori has increased, and little by little, has dazzled more about the pathophysiology of this organism, as the presence of genes involved in pathogenicity vacA, cagA, babA and sabA thereby indicating that is just a completely harmless bacteria, but neither of the major pathogen in stomach epithelium. Through this review is to cover some aspects of the bacteria, their relationship and benefi ts to the host and the pathological processes that can trigger their actions.