2008-01-012024-05-13https://scholars.lib.ntu.edu.tw/handle/123456789/651332Aims: A nationwide study to prospectively validate 1.the complete histological and molecular remission rate for antibiotics as 1st-line therapy for Hp-positive early-stage gastric lg- and hg-MALT lymphoma 2.the durability of complete histological remission after antibiotics 3.the usefulness of pattern of NF-kB and BCL-10 by IHC staining in prospectively predicting the Hp-dependence of gastric lg- and hg-MALT lymphoma 4.the frequency of t(11;18) translocation in gastric lg- and hg-MALT lymphoma in Taiwan. 5.the association between the CYP2C18/19 genetic polymorphisms and eradication of Hp infection after antibiotics. Expected Results: 1st-line antibiotic therapy will achieve complete histologic remission in 70-80% of Hp-positive stage IE gastric lg-MALT lymphoma and in 50-60% of stage IE hg-MALT lymphoma. The objective histologic CR rate in stage IIE-1 disease may be 30-40% for low-grade tumor and 20-30% for high-grade ones. The sensitivity and specificity of NF-kB and BCL-10 positive nuclear staining by IHC and of t(11;18) in predicting the Hp-independence will be both 80 – 90%. Ten – twenty per cent of enrolled patients will have CYP2C19 m1/m1, m1/m2 or m2/m2 genotypes (considered as omeprazole poor metabolizer), and they might have higher Hp eradication rate than those extensive metabolizers . Significance: The study will validate the use of antibiotics as first-line therapy for stage IE (and perhaps IIE-1) hg-MALT lymphoma. The status of NF-kB and BCL-10 IHC nuclear staining and of t(11;18) will help to tailoring the treatment for early stage gastric lg- and hg-MALT lymphoma. 50-60% of stage IE hg-MALT lymphoma patients can be cured by 2-weeks of antibiotics rather than the 6-months of relatively toxic front-line systemic chemotherapy. We shall also elucidate the distribution of CYP2C18/19 in patients with lg- and hg-MALT lymphoma and their association with the efficacy of OAC for eradication of Hp infection.mucosa-associated lymphoid tissue-type lymphomaHelicobacter pyloriimmunohistochemical staining