|Title:||Differential response to H. pylori eradication therapy of co-existing diffuse large B-cell lymphoma and MALT lymphoma of stomach - Significance of tumour cell clonality and BCL10 expression||Authors:||SUNG-HSIN KUO
|Issue Date:||2007||Journal Volume:||211||Journal Issue:||3||Start page/Pages:||296-304||Source:||Journal of Pathology||Abstract:||
We recently reported that low-grade mucosa-associated lymphoid tissue lymphoma (MALToma) and diffuse large B-cell lymphoma (DLBCL) with MALToma (DLBCL[MALT]) of stomach are equally responsive to H. pylori eradication therapy (HPET) and that H. pylori-independent status is closely associated with nuclear translocation of BCL10. However, co-existing MALToma and DLBCL components of gastric DLBCL(MALT) may respond differentially to HPET and the underlying mechanism remains unclear. Tumour tissue samples from 18 patients with microdissectable co-existing MALToma and DLBCL cells were studied. The clonality of lymphoma cells was examined by polymerase chain reaction-based amplification of the CDR3 region of the IgH gene and confirmed by DNA sequence analysis. BCL10 expression was determined by immunohistochemistry. Differential response of co-existing MALToma and DLBCL to HPET was defined as complete eradication of one component while the other component remained. Five (27.8%) of the 18 patients showed different IgH gene rearrangements in the two components and three (60%) of these five patients had differential response of MALToma and DLBCL to HPET. By contrast, 13 patients showed identical IgH gene rearrangements and only one (8%) of them had differential response of the two components to HPET (p = 0.044). Further, all four patients with differential response of MALToma and DLBCL to HPET showed nuclear expression of BCL10 in the H. pylori-independent component and cytoplasmic expression of BCL10 in the H. pylori-dependent component while the expression patterns of BCL10 were identical in both of these components in the 14 patients who had similar tumour response to HPET. We conclude that different clonality is a common reason for the differential response of co-existing MALToma and DLBCL of gastric DLBCL(MALT) to HPET and that immunohistochemical examination of BCL10 expression may help to identify the co-existence of these components. Copyright ? 2006 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.
|ISSN:||0022-3417||DOI:||10.1002/path.2117||SDG/Keyword:||amoxicillin; bismuth citrate; clarithromycin; DNA; immunoglobulin heavy chain; metronidazole; omeprazole; protein bcl 10; adult; aged; article; B cell lymphoma; cancer grading; cell nucleus; clinical article; clinical trial; clonal variation; comorbidity; complementarity determining region; controlled clinical trial; controlled study; cytoplasm; disease association; DNA sequence; drug substitution; drug withdrawal; eradication therapy; female; gastrectomy; gene amplification; gene rearrangement; Helicobacter infection; Helicobacter pylori; histopathology; human; human cell; human tissue; immunohistochemistry; lymphoma cell; male; mucosa associated lymphoid tissue lymphoma; polymerase chain reaction; priority journal; protein expression; protein localization; sequence analysis; stomach biopsy; stomach lymphoma; treatment outcome; tumor cell; Adaptor Proteins, Signal Transducing; Adult; Aged; Aged, 80 and over; Chi-Square Distribution; Clone Cells; Female; Follow-Up Studies; Gastric Mucosa; Gene Rearrangement; Helicobacter Infections; Helicobacter pylori; Humans; Immunoglobulin Heavy Chains; Immunohistochemistry; Lymphoma, B-Cell; Lymphoma, Large-Cell, Diffuse; Lymphoma, Mucosa-Associated Lymphoid Tissue; Male; Middle Aged; Stomach Diseases; Stomach Neoplasms; Tumor Markers, Biological
|Appears in Collections:||病理學科所|
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