MUCOSA-ASSOCIATED LYMPHOID-TISSUE (MALT) IN BARRETTS-ESOPHAGUS - PROSPECTIVE EVALUATION AND ASSOCIATION WITH GASTRIC MALT, MALT LYMPHOMA, AND HELICOBACTER-PYLORI

Objectives: Prospective evaluation of the prevalence of mucosa-associa ted lymphoid tissue (MALT) within Barrett's esophagus and its associat ion with gastric MALT, gastric MALT lymphoma, and H. pylori infection. Methods: From Barrett's esophagus patients, a minimum of six gastric biopsies were obtained, in addition to Barrett's surveillance biopsies . Additional gastric biopsies were taken from any ulcer(s), nodule(s), polyp(s), or other lesions, Patients with gastroesophageal reflux: sy mptoms without Barrett's esophagus served as controls, Results: One hu ndred and thirty-nine Barrett's patients were included in the study, O ne hundred and twenty-two of these patients had gastric biopsies for g astric MALT and H. pylori determination, H. pylori was noted in the st omach of 48 patients and within Barrett's mucosa in 14. Barrett's MALT was noted in seven cases, gastric MALT in 16, and gastric MALT lympho ma in two, None of the 101 control patients had esophageal MALT, Two o f the seven patients with Barrett's MALT had gastric MALT, Barrett)s M ALT was associated with esophageal H. pylori in 57.1% eases and gastri c H. pylori in 71.4%. The prevalence of gastric and esophageal H. pylo ri in patients with Barrett's MALT was significantly higher compared t o patients with Barrett)s without MALT (p < 0.0001 and p < 0.007, resp ectively). Barrett's MALT was very focal and its esophageal location v ariable, Conclusions: Barrett's MALT was associated with both esophage al and gastric H. pylori colonization, Esophageal MALT was associated with Barrett's esophagus, Gastric biopsy sampling is warranted ill any patient with Barrett's MALT to detect gastric MALT and H. pylori, whi ch, if found, should be eradicated.