LOWER RISK OF GASTRIC ATROPHY AND INTESTINAL METAPLASIA IN MALT LYMPHOMA PATIENT DESPITE OF H. PYLORI INFECTION
Joint Event on International Conference on SURGERY AND ANESTHESIA & 3rd International Conference on GASTROENTEROLOGY
November 12 -13 , 2018 | Rome , Italy
Sang Min Lee
The Catholic University College of Medicine, South Korea
Posters & Accepted Abstracts : Case Rep Surg Invasive Proced
Background/Aims: Atrophic gastritis and intestinal metaplasia are sequential consequences of chronic H. pylori infection. H. pylori infection is well known risk factor for gastric adenocarcinoma and malt lymphoma of stomach. Atrophic gastritis and intestinal metaplasia increases the risk of gastric adenocarcinoma development. The relationship between gastric malt lymphoma and atrophic gastritis-intestinal metaplasia is not on the spot of interest. We here investigated the clinical characteristics of gastric MALT lymphoma and co-presence of atrophic gastritis and intestinal metaplasia. Materials and methods: Study was conducted by review of electronic medical record of patients who were diagnosed with gastric malt lymphoma at an academic institute, the Yeouido St. Mary’s hospital, Seoul, Korea, from January 2001 to Mar 2018. Clinical characteristics and pathologic backgrounds including H. pylori infection positivity, atrophic gastritis and intestinal metaplasia were investigated. Results: A total of 47 subjects were enrolled consecutively during the study period and analyzed retrospectively. The mean age was 57.19-year-old (range 36 ~ 85). The male to female ratio was 1.19 (25/21). Endoscopic appearances varied; thirteen subjects presented ulcerative mass (28.26%), 12 (26.09%) flat atrophic patch of discoloration, 16 (34.78%) erosive patches, 2 (4.35%) multiple polypoid lesions and 3 (6.52%) sub epithelial tumor like appearance. H. pylori infection was proved in 82.6% (38 / 46). On histologic examination, background atrophic gastritis-intestinal metaplasia was accompanied in 28.26% (13/46). Serum pepsinogen I and II, as serological marker for atrophy, was evaluated in 17 subjects. Only 5 of 17 (29.41%) showed compatible with atrophic gastritis (pepsinogen I / II ratio of less than 3). Conclusion: The background mucosa of gastric malt lymphoma differs from that of gastric adenocarcinoma in terms of atrophic gastritisintestinal metaplasia. Less than 30% of gastric malt lymphoma accompanied background atrophic gastritis. Age can be a confounding factor. We will precede the age matched comparison between patients with gastric adenocarcinoma and malt lymphoma.
Sang Min Lee is a graduate of Kyungpook national university medical school in Korea and has completed major training at the department of internal medicine, the Catholic university of Korea. Currently, he is in training for fellowship at the department of internal medicine of Yeouido St. Mary’s hospital Sang Min Lee is majoring in gastroenterology and is working to become the best gastroenterologist & endoscopic specialist in South Korea.