SUNG-HSIN KUOKUN-HUEI YEHChen L.-T.CHUNG-WU LINPING-NING HSUCHIUN HSUMING-SHIANG WUTzeng Y.-S.Tsai H.-J.HSIU-PO WANGANN-LII CHENG2020-03-032020-03-0320142044-5385https://www.scopus.com/inward/record.uri?eid=2-s2.0-84903731249&doi=10.1038%2fbcj.2014.40&partnerID=40&md5=a58304958bbf6d2152f87e45bf9bd46ehttps://scholars.lib.ntu.edu.tw/handle/123456789/468851We recently showed that Helicobacter pylori (HP)-positive gastric 'pure' diffuse large B-cell lymphoma (DLBCL) may respond to HP eradication therapy. However, whether these HP-related 'pure' DLBCL of the stomach may differ fundamentally from those unrelated to HP remains unclear. In this study, we compared the clinicopathologic features of these two groups of patients who had been uniformly treated by conventional chemotherapy. Forty-six patients were designated HP-positive and 49 were HP-negative by conventional criteria. HP-positive patients had a lower International Prognostic Index score (0-1, 65% vs 43%, P=0.029), a lower clinical stage (I-IIE1, 70% vs 39%, P=0.003), a better tumor response to chemotherapy (complete pathologic response, 76% vs 47%, P=0.004) and significantly superior 5-year event-free survival (EFS) (71.7% vs 31.8%, P<0.001) and overall survival (OS) (76.1% vs 39.8%, P<0.001). To draw a closer biologic link with HP, HP-positive tumors were further examined for CagA expression in lymphoma cells. Compared with CagA-negative cases (n=16), CagA-positive cases (n=27) were associated with high phosphorylated SHP-2 expression (P=0.016), and even better 5-year EFS (85.2% vs 46.3%, P=0.002) and OS (88.9% vs 52.9%, P=0.003). HP-related gastric 'pure' DLBCL may be a distinct tumor entity, which is less aggressive, and responds better to conventional chemotherapy. ? 2014 Macmillan Publishers Limited.[SDGs]SDG3CagA protein; cyclophosphamide; doxorubicin; epirubicin; etoposide; mitoxantrone; prednisolone; protein tyrosine phosphatase SHP 2; rituximab; vincristine; bacterial antigen; bacterial protein; cagA protein, Helicobacter pylori; adult; article; cancer prognosis; cancer staging; chemosensitivity; controlled study; eradication therapy; event free survival; female; gastrectomy; Helicobacter infection; Helicobacter pylori; histopathology; human; International Prognostic Index; large cell lymphoma; lymphoma cell; major clinical study; male; overall survival; protein expression; protein phosphorylation; recurrence free survival; stomach lymphoma; treatment response; biosynthesis; disease free survival; Helicobacter infection; Helicobacter pylori; isolation and purification; Lymphoma, Large B-Cell, Diffuse; metabolism; microbiology; middle aged; pathology; pathophysiology; prognosis; Stomach Neoplasms; Antigens, Bacterial; Bacterial Proteins; Disease-Free Survival; Female; Helicobacter Infections; Helicobacter pylori; Humans; Lymphoma, Large B-Cell, Diffuse; Male; Middle Aged; Prognosis; Stomach Neoplasmsjournal article10.1038/bcj.2014.40249498572-s2.0-84903731249