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

Song,Yan; Jiang,Kui; Su,Shuai; Wang,Bangmao; Chen,Guangxia

doi:10.3892/etm.2017.5413

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

Authors:
- Yan Song
- Kui Jiang
- Shuai Su
- Bangmao Wang
- Guangxia Chen
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Affiliations: Department of Gastroenterology, Tianjin Medical University General Hospital, Tianjin 300052, P.R. China, Department of Gastroenterology, No. 2 Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300151, P.R. China
Published online on: November 1, 2017 https://doi.org/10.3892/etm.2017.5413
Pages: 553-561

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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.

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