Clinical manifestations and epigenetic mechanisms of gastric mucosa associated lymphoid tissue lymphoma and long‑term follow‑up following Helicobacter�pylori eradication

Abstract

Abstract. The current study aimed to summarize the clinical manifestations and identify the epigenetic mechanisms of gastric mucosa associated lymphoid tissue (MALT) lymphoma, as well as evaluate the long-term effects of Helicobacter pylori (H. pylori) eradication. A total of 122 patients with marginal zone B-cell lymphoma of primary gastric MALT lymphoma were enrolled in the present study. The clinical manifestations of gastric MALT lymphoma, including symptoms, H. pylori state and endoscopic type, were summarized. The response to therapy was evaluated in patients that underwent H. pylori eradication. Survival analysis was estimated using the Kaplan-Meier method. The expression of microRNA-383 (miR-383) in tumor tissues and cell lines was determined using reverse transcription quantitative polymerase chain reaction. Furthermore, bioinformatic analyses, luciferase reporter assays. and western blot analysis identified zinc finger E-box binding homeobox 2 (ZEB2) as a direct target gene of miR-383. An MTT assay was used to examine the function of miR-383 and ZEB2 in MALT lymphoma. The clinical symptoms of patients with gastric MALT lymphoma were non-specific and included epigastric pain, abdominal discomfort and bleeding. The majority of endoscopic types were classified as ulcer, erosion and mucosa edema. The H. pylori infection rate was 79.5% (97/122) and a total of 47 patients underwent eradication therapy. Lymphoma remission was achieved in 93.6% (44/47) of patients and complete remission (CR) was achieved in 74.4% (35/47). The median follow-up time was 38 months (range, 10-132 months) and the median time taken to achieve CR was 4 months (range, 3-7 months). The estimated 3-year survival rate was 90.3% and the 5-year survival rate was 76.2%. Therefore, it was determined that patients with stage I or II gastric MALT lymphoma are able to undergo H. pylori eradication as a first-line treatment and that the survival rate of patients undergoing this treatment is high. Furthermore, it was determined that the mechanism by which miR-383 and ZEB2 contribute to MALT lymphoma progression is by the targeting of ZEB2 by miR-383, which inhibits the proliferation of cancer cells.

hsa_circ_0092306 Targeting miR-197-3p Promotes Gastric Cancer Development by Regulating PRKCB in MKN-45 Cells

“…The underlying mechanism of miR-197-3p downregulation induced by the overexpression of hsa_circ_0092306 needs to be revealed in future studies. In addition, according to the Circular RNA Interactome website, apart from the miR-197-3p, the tumor suppressors miR-198 32 and miR-383 33 also show a high context with the hsa_circ_0092306 binding score. Similarly, miR-197-3p targets many genes predicted by TargetScan in addition to PRKCB.…”

Low-Stage Gastric MALT Lymphoma Causing Life-Threatening Upper Gastrointestinal Bleeding

“…Ulcers are the most common etiology of upper GI bleeding (59%), compared to malignancies (2–4%) [1]. Gastric MALT lymphoma has been reported to manifest as upper GI bleeding upon diagnosis in only 15.6% of the cases [4]. The presentation of massive bleeding with hypovolemic shock is very rare as the first sign of gastric MALT lymphoma, especially in an early stage – in this case, stage IE.…”

“…Complete remission was achieved in 74.4% of patients who underwent eradication therapy, after a median time of around 4 months. A study showed that the 3-year and 5-year survival rates were 90.3 and 76.2%, respectively [4]. Even after remission, relapse and reinfection with H. pylori should be monitored, as well as the risk of gastric adenocarcinoma, because the risk is 6-fold increased in patients with gastric MALT compared to the general population [15].…”

“…Extranodal lymphoma of the non-Hodgkin type accounts for 24–48% of all lymphoma cases [3]. The GI tract is the most common site of extranodal lymphoma, estimated to be the site of around 30–45% of all extranodal lymphomas; the stomach is the most common site [4].…”

“…Histologically, primary gastric lymphoma is divided into several different types according to the Revised European-American Classification of Lymphoid Neoplasms (REAL), with diffuse large B-cell lymphoma being the most common (comprising 59% of the cases), followed by mucosa-associated lymphoid tissue (MALT) lymphoma in 38% of the cases [5]. Primary gastric lymphoma is a rare disease, comprising only about 1–6% of all tumors of the stomach [4]. Gastric lymphoma originating from MALT is strongly related to Helicobacter pylori infection or chronic antigenic stimulation.…”