Histological transformation from gastric mucosa-associated lymphoid tissue lymphoma to gastric diffuse large B-cell lymphoma

Li,Xiaowu; Meng,Qingliang; Sun,Sanyuan; Zhan,Zhongli; Zhang,Lianyu; Sun,Baochun; Zhang,Yizhuo

doi:10.3892/ol.2017.6402

Histological transformation from gastric mucosa-associated lymphoid tissue lymphoma to gastric diffuse large B-cell lymphoma

Authors:
- Xiaowu Li
- Qingliang Meng
- Sanyuan Sun
- Zhongli Zhan
- Lianyu Zhang
- Baochun Sun
- Yizhuo Zhang
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Affiliations: Department of Medical Oncology, Xuzhou Central Hospital, Xuzhou, Jiangsu 277100, P.R. China, Department of Oncological Surgery, Xuzhou Central Hospital, Xuzhou, Jiangsu 277100, P.R. China, Department of Pathology, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, P.R. China, Department of Hematology, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, P.R. China
Published online on: June 16, 2017 https://doi.org/10.3892/ol.2017.6402
Pages: 2244-2248
Copyright: © Li et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

This study evaluated the clinical features, treatment and prognosis in Chinese patients with histological transformation (HT) from gastric mucosa-associated lymphoid tissue lymphoma to gastric diffuse large B-cell lymphoma. We reviewed the medical records of 71 patients diagnosed with HT between 2001 and 2013, retrospectively. Patients had a median age of 56 years. The ratio of sex (male:female) was 1.3:1. The clinical course was often insidious, lacking specific clinical presentation. Macroscopically, the antrum was the most commonly involved site. Thirty-one patients (45%) presented at stage I, and 25 (35%) presented with local (18/71, 25%) or distant (7/71, 10%) nodal involvement. There were also stage IIE (9/71, 12%) and stage IV (6/71, 8%) patients with advanced stages. For all 71 patients, the 5-year progression‑free survival (PFS) and overall survival (OS) estimates were 50 and 56%, respectively. There was no statistical difference in 5-year PFS and OS estimates between patients receiving Helicobacter pylori (H. pylori) containing eradication (HPE) (p=0.189) and those receiving non‑HPE (p=0.359). Upon the Cox regression model, advanced stages were the only independent prognostic factors associated with shorter PFS, and m-IPI was independently associated with shorter PFS and OS. There was no specific clinical manifestation for patients with HT. HPE is thus a promising therapeutic approach for such patients. Moreover, advanced stages and m-IPI significantly influenced patient outcome.

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