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단클론성 유무가 저등급 위점막연관림프조직형 림프종의 임상양상 및 제균요법 후 초기 조직학적 관해에 미치는 영향
김진호,홍원선,민영일,정훈용,명승재,강경훈,김기락,허주령,최승목,심용희,이숭한,양석군 대한소화기학회 2001 대한소화기학회지 Vol.37 No.4
Background/Aims: There has been little description about the clinical significance of B-cell monoclonality in primary low-grade gastric mucosa-associated lymphoid tissue (MALT) lymphoma. We investigated the effects of B-cell monoclonality on early response to Helicobacter pylori (H. pylori) eradication therapy in patients with H. pylori-positive low-grade gastric MALT lymphoma. Methods: Twenty-nine patients with H. pylori-positive low-grade gastric MALT lymphoma were consecutively enrolled. We performed diagnostic tests including esophagogastroduodenoscopy (EGD), endoscopic ultrasonography and CT scan for the patients. PCR with PAGE was used to analyse the patterns of immunoglobulin heavy chain gene rearrangement. All 29 patients received H. pylori-eradication therapy. They were then followed up at regular intervals by EGD with biopsy. Results: Fifty-five percent (16/29) showed a single band in PAGE after PCR, suggesting a monoclonal proliferation of B-cell lineage. Regardless of B-cell monoclonality, there was no difference in histologic regression rates after 3 months of eradication therapy. However, the MALT lymphomas with B-cell monoclonality showed more ulcerous lesions (p$lt;0.01) and deeper infiltration of tumor into gastric wall (p$lt;0.05) than those without B-cell monoclonality. Conclusions: These results suggest that PCR-based B-cell monoclonality may not affect early therapeutic response to H. pylori-eradication therapy in gastric MALT lymphoma in spite of the more aggressive histologic morphology.