제균 치료에 반응하지 않은 유전자 전좌를 동반한 MALT 위림프종 1예
A case of an API2-MALT1 translocation-positive gastric MALT lymphoma resistant to Helicobacter pylori eradication
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초록
H. pylori 음성인 위 MALT 림프종의 치료는 확립되어 있지 않으며 제균 치료의 효과도 예측하기 어렵다. 최근 API2- MALT1 키메라 유전자의 존재가 제균 치료의 유효한 예측 인자로 밝혀졌고, 이에 따라 새로운 치료 방법을 고려해야 한다는 주장이 제기되고 있다. 저자들은 H. pylori 제균 치료에 반응하지 않은 API2-MALT1 유전자 전좌를 동반한 위 MALT 림프종 1예를 경험하였기에 문헌 고찰과 함께 보고한다.
Abstract
About 90% of low-grade gastric mucosa-associated lymphoid tissue (MALT) lymphomas are strongly related to Helicobacter pylori infection. The eradication of the H. pylori by antibiotics leads to complete regression of the gastric MALT lymphoma in 80% of cases, and this is currently recommended as the first-line treatment for this tumor. However, no standard treatment for H. pylori-negative and H. pylori-eradication-resistant gastric MALT lymphomas has yet been devised. The association between H. pylori-negative MALT lymphoma and the t(11;18)(q21;q21) translocation, resulting in an API2-MALT1 chimera gene, was reported, and is now considered one of the possible causes of and a reliable predictive marker for unresponsiveness to H. pylori-eradication treatment in patients with low-grade gastric MALT lymphoma. We report a case of H. pylori-eradication-treatment-resistant low-grade gastric MALT lymphoma that was treated successfully with radiotherapy after recognizing the API2-MALT1 chimera gene.
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