Comparative analysis of the Helicobacter pylori status in patients with gastric Malt-type lymphoma and their respective spouses[1]*

Summary

Helicobacter pylori is of major importance for the development and progression of gastric MALT-type lymphoma. In case of localized low grade lymphoma successfully treated by Helicobacter pylori eradication reinfection by the bacterium may involve the risk of lymphoma reoccurence.

Aims: To assess the frequency and type of Helicobacter pylori infection among patients with gastric MALT-type lymphoma and their respective spouses as potential sources of person to person spread of the infection.

Subjects: 35 patients with gastric MALT-type lymphoma and their cohabiting spouses.

Methods: We investigated serum IgG titers in response to the infection by Helicobacter pylori and to its virulence factors CagA and VacA by enzyme linked immunosorbent assay (ELISA) and by Western blot.

Results: Seropositivity of Helicobacter pylori, Cag A and Vac A was found to be 100/89/69 % and 97/86/66 % in patients and respective partners, respectively. The seroprevalence rates of the latter group by far exceed those of the German population.

Conclusion: These data provide evidence for a high Helicobacter pylori infection rate in both patients with gastric MALT-type lymphoma and their respective spouses. Considering the latter as a potential source of reinfection with the risk of lymphoma reoccurence for the successfully treated patient with gastric MALT-type lymphoma careful follow-up seems highly reasonable to decide on the necessity of a future test-and-treat strategy of this population.

Helicobacter-pylori-Status bei Patienten mit MALT-Lymphomen des Magens und ihren Lebenspartnern

Helicobacter pylori ist von entscheidender Bedeutung für die Entstehung und Progression von MALT-Lymphomen des Magens. Im Falle lokalisierter Lymphome niedriger Malignität beinhaltet eine Reinfektion nach erfolgreicher Eradikation und Lymphom­regression das Risiko eines Rezidivs. Wir untersuchten daher die Häufigkeit und den Typ der Helicobacter-pylori-Infektion bei 35 Patienten mit gastralen MALT-Lymphomen und ihren Partnern, die eine potenzielle Quelle für eine direkte Übertragung dar­stellen.

Methode: Serum-IgG-Titer für Helicobacter pylori und die Virulenzfaktoren CagA und VacA wurden mittels ELISA und Western blot analysiert.

Ergebnisse: Eine Seropositivität für Helicobacter pylori, CagA und VacA fand sich bei 100/89/69 % der Patienten und bei 97/86/66 % ihrer Partner. Die Seroprävalenzraten der Partner übersteigen damit bei weitem die Infektionsraten in der deutschen Bevölkerung.

Schlussfolgerung: Sowohl bei Patienten mit MALT-Lymphomen des Magens als auch bei ihren Partnern besteht eine hohe Infektionsrate mit Helicobacter pylori. Angesichts einer potenziellen Reinfektion mit dem Risiko eines Lymphomrezidivs sind sorgfältige Kontrolluntersuchungen nötig, um zukünftig über die Notwendigkeit einer „Teste-und-behandle-Strategie” der Partner von Lymphompatienten zu entscheiden.

Key words

Helicobacter pylori - Cag A - Vac A; - MALT lymphoma - Spouses

Schlüsselwörter

Helicobacter pylori - CagA - VacA - MALT-Lymphom - Partner

1 These data have been presented at the Digestive Disease Week, Orlando, Florida 1999 and published as abstract (Gastroenterology 1999; 116: A403)

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Fußnoten

1 These data have been presented at the Digestive Disease Week, Orlando, Florida 1999 and published as abstract (Gastroenterology 1999; 116: A403)

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