저위도 점막연관림프조직형 위 림프종의 내시경 소견과 치료에 대한 장기 성적보고

Abstract

Background/Aims: We aimed to evaluate the long-term outcome of patients with MALT lymphoma in respect to various treatment modalities and clinicopathologic characteristics, including endoscopic findings. We also tried to deduce suitable strategic guideline to treat MALT lymphoma. Methods: We retrospectively studied 55 patients primary low-grade gastric MALT lymphoma that were diagnosed between May 1992 and August 2002. Results: The majority of endoscopic findings showed lesions with ulceration or with color and surface change of mucosa. All but one was H. pylori positive when tested. Treatment modalities included anti H. pylori treatment, radiation, surgery and/or chemotherapy. Eradication was successful in all the 29 patients associated with H. pylori infection. Complete remission was obtained in 24(82.8%). Only one patient suffered a relapse after 28 months during the follow up(2 ~ 74 months). The duration to reach complete remission was 12 months (85 percentile, 2 ~ 33 months). Six patients showed complete remission with radiation therapy. Two of them were H. pylori treatment failure cases. One of 14 patients treated by surgery displayed relapse during follow-up (12 ~ 120 months). Endoscopically, the ulcerative and/or the protruding type showed unfavorable response to anti H. pylori treatment. Conclusion: H. pylori eradication alone should be considered as an initial treatment for MALT lymphoma and radiation therapy could be preferred in patients with no evidence of H. pylori infection or who do not response to H. pylori eradication therapy 12 months after successful eradication.