Lečenje MALT limfoma želuca niskog stepena maligniteta eradikacijom Helicobacter pylori infekcije

  • Saša Grgov Department of Gastroenterology and Hepatology, General Hospital Leskovac, Leskovac, Serbia
  • Vuka Katić Polyclinic Human, Niš, Serbia
  • Miljan Krstić Institut of Pathology, Faculty of Medicine Niš, University of Niš, Serbia
  • Aleksandar Nagorni Clinic of Gastroenterology and Hepatology, Clinical Center Niš, Niš, Serbia
  • Biljana Radovanović - Dinić Clinic of Gastroenterology and Hepatology, Clinical Center Niš, Niš, Serbia
  • Tomislav Tasić Department of Gastroenterology and Hepatology, General Hospital Leskovac, Leskovac, Serbia
DOI: https://doi.org/10.2298/4555
Ključne reči: lymphoma, b-cell, marginal zone||, ||limfom, malt, želudac, , stomach neoplasms||, ||neoplazme, helicobacter pylori||, ||helicobacter pylori, drug therapy||, ||lečenje lekovima, remission induction||, ||remisija, indukcija, prognosis||, ||prognoza, histology||, ||histologija

Sažetak


Uvod/Cilj. Limfom limfnog tkiva mukoze (MALT limfom) želuca najčešće nastaje kao posledica Helicobacter pylori (H. pylori) infekcije. Cilj studije bio je da se ispita dugotrajni efekat lečenja MALT limfoma želuca niskog stepena maligniteta eradikacijom H. pylori infekcije. Metode. U periodu od 2002. do 2012. godine kod 20 pacijenata sa simptomima dispepsije, prosečne starosti 55,1 godinu, endoskopski i histološki je dijagnostikovan MALT limfom želuca u ranoj fazi. Histološki preparati endoskopskih biopsijskih uzoraka bojeni su klasičnom hematoksilin-eozin (HE) metodom, histohemijskim i imunohistohemijskim metodama. Rezultati. Endoskopski nalaz gastritisa imalo je 25% bolesnika, dok je 75% bolesnika imalo hipetrofiju nabora, jaku hiperemiju mukoze, fragilnost, nodularnost, egzulceracije i rigiditet. Patohistološki, patognomoničan dijagnostički kriterijum bila je infiltracija i razaranje žlezdanog epitela neoplastičnim limfoidnim ćelijama, odnosno limfoepitelijalna lezija. Kod svih 20 bolesnika bio je verifikovan H. pylori brzim ureaza testom i modifikovanom Giemsa metodom. Nakon trojne eradikacione terapije potpuna remisija MALT limfoma postignuta je kod 85% bolesnika, bez recidiva limfoma i H. pylori infekcije u prosečnom periodu praćenja od 48 meseci. Kod 3 (15%) bolesnika nije došlo do remisije MALT limfoma 12 meseci od eradikacione terapije. Kod dva od ova tri bolesnika došlo je do progresije MALT limfoma u difuzni krupno ćelijski limfom. Zaključak. Potpuna dugotrajna remisija MALT limfoma želuca niskog stepena maligniteta postiže se u visokom procentu posle eradikacije H. pylori infekcije. Na taj način sprečava se nastanak difuznog krupnoćelijskog limfoma, kao i adenokarcinoma želuca.

Biografije autora

Saša Grgov, Department of Gastroenterology and Hepatology, General Hospital Leskovac, Leskovac, Serbia
Sef odeljenja za gastroenterologiju i hepatologiju
Vuka Katić, Polyclinic Human, Niš, Serbia

Emeritus professor

Polyclinic Human, Nis

Miljan Krstić, Institut of Pathology, Faculty of Medicine Niš, University of Niš, Serbia
Doc.dr , School of Medicine , University  of NIs.
Aleksandar Nagorni, Clinic of Gastroenterology and Hepatology, Clinical Center Niš, Niš, Serbia
Prof.dr, School of Medicine, University of NIs.
Biljana Radovanović - Dinić, Clinic of Gastroenterology and Hepatology, Clinical Center Niš, Niš, Serbia
Doc.dr School of Medicine, University of NIs.
Tomislav Tasić, Department of Gastroenterology and Hepatology, General Hospital Leskovac, Leskovac, Serbia
Shef of Clinical section for gastroenterology and hepatology, Specialist internist gastroenterologist.

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Objavljeno
2015/07/08
Broj časopisa
Vol. 72 Br. 5 (2015)
Rubrika
Originalni članak