胃MALTリンパ腫除菌治療後のサーベイランス―発生と進展からみて

Surveillance for Gastric MALT Lymphoma after H. pylori Eradication

要旨　胃MALTリンパ腫のH. pylori除菌療法後の長期経過を検討し，二次治療への移行を早期に判断すべき症例の選別，経過観察例でのサーベイランスについて検討した．除菌療法を受けた80例中，H. pylori陽性68例での奏効率は75％であるのに対し，陰性12例では8％であり早期に二次治療への移行を判断すべきと考えられた．2年以上の経過観察例のうちH. pylori陽性54例では39例がCRに至り，6か月以内にCR inに至った症例は47％，24か月以内では92％であった．内視鏡所見の改善は97％の症例で認められた．H. pylori陽性例ではNCでも内視鏡的改善が認められれば長期の経過観察が可能であると考えられた．

　We studied the clinical course of patients with gastric MALT lymphoma after eradication of H. pylori and investigated, during the follow-up period in CR cases, features of patients who need early-term secondary therapy and surveillance. In 68 H. pylori positive cases after eradication, the rate of response was 75 ％, and in 12 H. pylori negative cases, it was 8 ％. In patients followed up during more than 2 years, 47 ％ of 39 CR cases improved to CR in within 6 months and 92 ％ within 24 months. Endoscopic improvement was recognized in 97 ％. Since, in cases positive for H. pylori, improvement can be detected endoscopically even in cases which presently show no change (NC) in histological evaluation, so it was considered that long-term observation may as well be continued.

　1) Endoscopy Division, National Cancer Center Hospital, Tokyo