Helicobacter pylori除菌非奏効病変の特徴―胃MALTリンパ腫：臨床

Clinical Management for Non-responders with Gastric Low-grade MALT Lymphoma after H. pylori Eradication Therapy

要旨　H. pylori陽性かつ限局期の胃MALTリンパ腫に対するH. pylori除菌は，第一選択の治療法として定着しつつあるが，除菌非奏効例に対する臨床的取り扱いが問題となっている．われわれは，除菌療法が施行された胃MALTリンパ腫74例（うち非奏効例26例）について検討を行い，肉眼型では隆起・潰瘍型が，また除菌前H. pylori陰性例では除菌に抵抗性であり，また経過中の増悪も来しやすいことから適切な二次治療へ速やかに移行するべきと考えられた．

　It has been accepted that H. pylori eradication therapy is the first choice for patients with gastric low grade MALT lymphoma. However, we have no strategy based on evidence for non-responders after eradication therapy. We reviewed 26 out of a total of 74 cases who were non-responder after eradication therapy. In cases classified macroscopically as protruded and ulcerative types and which were initially H. pylori negative patients, second therapy rather than mere observation is recommended.