胃と腸39巻3号

2004年03月発行

今月の主題 胃MALTリンパ腫―除菌治療後の経過と予後 主題

胃MALTリンパ腫除菌治療後の長期経過と予後―t(11；18)(q21；q21)転座とEUSを中心に

著者： 中村常哉¹ 稲垣宏² 横井太紀雄³ 中村栄男³

所属機関： ¹愛知県がんセンター消化器内科 ²名古屋市立大学臨床病態病理学 ³愛知県がんセンター遺伝子病理診断部

ページ範囲：P.285 - P.294

要旨　胃MALTリンパ腫の病態はt(11;18)(q21;q21)転座（API2-MALT1キメラ遺伝子）の有無と除菌療法に対する反応性で3群（A，B，C群）に分類される．A群はAPI2-MALT1陰性でresponderの群，B群はAPI2-MALT1陰性でnon-responderの群，C群はAPI2-MALT1陽性でnon-responderの群である．その特徴は，A群はH. pylori陽性・深達度はSMまで・臨床病期がI期であり，長期にわたり再発を認めない．B群は深達度MP以深・臨床病期II1期以上・diffuse large B-cell lymphoma成分を有する例が多く，肉眼型は隆起型が目立つ．C群はH. pylori陰性・臨床病期II1期以上の例が多く，diffuse large B-cell lymphoma成分は認めず，肉眼型はcobblestone粘膜が特徴的である．API2-MALT1の検索とEUSによる進展度診断は除菌の反応性を予測する有用な手段である．

参考文献

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19）宮林秀晴，赤松泰次，望月太郎，他．Helicobacter pylori除菌治療により完全寛解した後，局所再発したMALTリンパ腫の1例．胃と腸 37 : 589 -593, 2002