Malignant tumors of the stomach - Gastric mucosa-associated lymphoid tissue lymphoma and Helicobacter pylori

With the help of many clinical studies, the diagnosis and therapy of gastri c mucosa-associated lymphoid tissue (MALT) lymphoma have evolved. Major pro gress has been seen in this area, including improvement of biopsy diagnosis , better histologic classification, new information concerning pathogenesis , and, especially the start of a revolution in the treatment of low-grade g astric MALT lymphomas by eradicating Helicobacter pylori. There still ale q uestions that need to be addressed, however, including the exact mechanisms that lead to the malignant transformation, why approximately 20% of low-gr ade MALT lymphomas do not regress after H. pylori eradication, if there is a molecular-genetic or immunologic point of no return, the biologic signifi cance of the immunoglobulin rearrangement detected with polymerase chain re action, and the 5- and 10-year relapse-free survival rates of patients suff ering from low-grade MALT lymphoma treated with H. pylori eradication alone as the first and only treatment. The wave of new data each year about the role of H. pylori in gastric MALT lymphoma may help many of these questions to be answered.