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Multicenter Study
. 2017 Sep 7;23(33):6155-6163.
doi: 10.3748/wjg.v23.i33.6155.

Management of gastric mucosa-associated lymphoid tissue lymphoma in patients with extra copies of the MALT1 gene

Masaya Iwamuro  1 , Ryuta Takenaka  2 , Masahiro Nakagawa  3 , Yuki Moritou  4 , Shunsuke Saito  5 , Shinichiro Hori  6 , Tomoki Inaba  7 , Yoshinari Kawai  8 , Tatsuya Toyokawa  9 , Takehiro Tanaka  10 , Tadashi Yoshino  11 , Hiroyuki Okada  12
Affiliations
Multicenter Study

Management of gastric mucosa-associated lymphoid tissue lymphoma in patients with extra copies of the MALT1 gene

Masaya Iwamuro et al. World J Gastroenterol. .

Abstract

Aim: To identify the clinical features of gastric mucosa-associated lymphoid tissue (MALT) lymphoma with extra copies of MALT1.

Methods: This is a multi-centered, retrospective study. We reviewed 146 patients with MALT lymphoma in the stomach who underwent fluorescence in situ hybridization analysis for t(11;18) translocation. Patients were subdivided into patients without t(11;18) translocation or extra copies of MALT1 (Group A, n = 88), patients with t(11;18) translocation (Group B, n = 27), and patients with extra copies of MALT1 (Group C, n = 31). The clinical background, treatment, and outcomes of each group were investigated.

Results: Groups A and C showed slight female predominance, whereas Group B showed slight male predominance. Mean ages and clinical stages at lymphoma diagnosis were not different between groups. Complete response was obtained in 61 patients in Group A (69.3%), 22 in Group B (81.5%), and 21 in Group C (67.7%). Helicobacter pylori (H. pylori) eradication alone resulted in complete remission in 44 patients in Group A and 13 in Group C. In Group B, 14 patients underwent radiotherapy alone, which resulted in lymphoma disappearance. Although the difference was not statistically significant, event-free survival in Group C tended to be inferior to that in Group A (P = 0.10).

Conclusion: Patients with t(11;18) translocation should be treated differently from others. Patients with extra copies of MALT1 could be initially treated with H. pylori eradication, similar to patients without t(11;18) translocation or extra copies of MALT1.

Keywords: 18) translocation; Esophagogastroduodenoscopy; Extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue; Gastric neoplasms; Trisomy 18; t(11.

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Conflict of interest statement

Conflict-of-interest statement: All of the authors declare that they have no conflicts of interest associated with this article.

Figures

Figure 1
Figure 1
FISH images of the lymphoma cells. In the FISH analysis for t(11;18)(q21; q21) translocation, API2 is visualized as a green signal and MALT1 as a red signal. A: Two green signals and two red signals are seen in cases without t(11;18) translocation or extra copies of MALT1. B: Fusion genes of API2-MALT1 are detected as yellow signals, indicating t(11;18) translocation (B, arrows). C: Although no fusion genes are visible, an extra copy of MALT1 is noted, indicating trisomy 18. D: Two extra copies of MALT1 are visible, indicating tetrasomy 18. E: In one patient, several lymphoma cells have six MALT1 signals with four API2 signals, which is considered as trisomy 18 with tetraploidy.
Figure 2
Figure 2
Cumulative event-free probabilities for the three groups. Although event-free survival of Group C patients appears to be inferior to that of the patients of the other two Groups, log-rank test revealed that the difference between Groups A and C was not statistically significant (P = 0.10).
See this image and copyright information in PMC

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