Helicobacter Pylori除菌療法後の胃MALTリンパ腫と濾胞性胃炎の形態変化―内視鏡像を中心に

Morphological Changes of MALT lymphoma of the Stomach and Follicular Gastritis after Antibiotic Treatment for Helicobacter pylori

要旨　近年，Helicobacter Pyloriとリンパ腫をはじめとした胃リンパ増殖性疾患との関連が注目されてきている．今回，Helicobacter Pylori陽性のMALTリンパ腫4例および濾胞性胃炎3例に除菌療法を施行し，その後の形態変化を内視鏡所見を中心に検討した．MALTリンパ腫で除菌に成功したものは3例であったが，除菌療法を試みた4例すべてに内視鏡的な改善が認められた．除菌が不成功であった1例もHelicobacter pyloriの菌体量の減少が認められ，腫瘍組織は消失した．しかし，除菌に成功し内視鏡的にも改善を認めているが，腫瘍細胞の完全消失には至っていない症例が1例存在した．また，濾胞性胃炎の3例すべてに除菌が確認され，組織学的には3例とも炎症細胞浸潤は改善していたが，内視鏡的には1例にわずかな所見の改善を認めたのみで，ほかの2例は不変であった．

　Recently, relationship between Helicobacter pylori (H. pylori) and lymphoproliferative disorders of the stomach has been recognized.

　Morphological changes of lesions after antibiotic treatment for H. pylori were investigated endoscopically and histologically in four patients with MALT lymphoma of the stomach and in three with follicular gastritis who were positive for H. pylori infection.

　Eradication of H. pylori was successful in three out of four patients with MALT lymphoma and endoscopical findinds became less prominent in all four patients with treatment. Antibiotic treatment could not eradicate H. pylori infection in a patient, but reduce the number of organisms histologically. In a patient who became negative for H. pylori, lymphoma cells remained in spite of improvement of endoscopic findings.

　Although eradication of H. pylori was successful in all three patients with follicular gastritis, antibiotic treatment did not change endoscopic findings in two patients and brought a little improvement in a patient.