First-line antibiotic therapy in Helicobacter pylori-negative low-grade gastric mucosa-associated lymphoid tissue lymphoma

• Published in: Scientific reports 2017-10, Vol.7 (1), p.14333-13, Article 14333
• Main Authors: Kuo, Sung-Hsin, Yeh, Kun-Huei, Wu, Ming-Shiang, Lin, Chung-Wu, Wei, Ming-Feng, Liou, Jyh-Ming, Wang, Hsiu-Po, Chen, Li-Tzong, Cheng, Ann-Lii
• Format: Article
• Language: English
• Subjects: 13/51; 14/32; 14/63; 631/337; 631/67; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents - therapeutic use; Antibiotics; Antineoplastic Agents - therapeutic use; B-Cell CLL-Lymphoma 10 Protein - genetics; B-Cell CLL-Lymphoma 10 Protein - metabolism; Bcl-10 protein; Biomarkers; Drug Resistance, Neoplasm - genetics; Female; Gastric mucosa; Gastric Mucosa - pathology; Gene Expression Regulation, Neoplastic; Helicobacter pylori; Helicobacter pylori - physiology; Humanities and Social Sciences; Humans; Lymphoid Tissue - pathology; Lymphoma; Lymphoma - drug therapy; Male; Middle Aged; Mucosal-associated lymphoid tissue; Mucous membrane; multidisciplinary; NF-kappa B - genetics; NF-kappa B - metabolism; NF-κB protein; Remission; Science; Science (multidisciplinary); Serology; Stomach Neoplasms - drug therapy; Treatment Outcome; Tumors; Urea; Urease; Young Adult
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-017-14102-8

First-line antibiotic treatment for eradicating Helicobacter pylori (HP) infection is effective in HP-positive low-grade gastric mucosa-associated lymphoid tissue lymphoma (MALToma), but its role in HP-negative cases is uncertain. In this exploratory retrospective study, we assessed the outcome and potential predictive biomarkers for 25 patients with HP-negative localized gastric MALToma who received first-line HP eradication (HPE) therapy. An HP-negative status was defined as negative results on histology, rapid urease test, 13 C urea breath test, and serology. We observed an antibiotic response (complete remission [CR], number = 8; partial remission, number = 1) in 9 (36.0%) out of 25 patients. A t(11;18)(q21;q21) translocation was detected in 7 (43.8%) of 16 antibiotic-unresponsive cases, but in none of the 9 antibiotic-responsive cases (P = 0.027). Nuclear BCL10 expression was significantly higher in antibiotic-unresponsive tumors than in antibiotic-responsive tumors (14/16 [87.5%] vs. 1/9 [11.1%]; P = 0.001). Nuclear NF-κB expression was also significantly higher in antibiotic-unresponsive tumors than in antibiotic-responsive tumors (12/16 [75.0%] vs. 1/9 [11.1%]; P = 0.004). A substantial portion of patients with HP-negative gastric MALToma responded to first-line HPE. In addition to t(11;18)(q21;q21), BCL10 and NF-κB are useful immunohistochemical biomarkers to predict antibiotic-unresponsive status in this group of tumors.