Effet du traitement d’éradication d’Helicobacter pylori sur la réponse du lymphome MALT-Gastrique

Introduction: The link between gastric mucosa-associated lymphoid tissue lymphoma (LG-MALT) and chronic Helicobacter Pylori (HP) infection had led to a real revolution in the management of the disease. Aims: To study the results of the HP eradication therapy and to clarify its place in the tumor response. Methods: A descriptive retrospective bicentric study, between January 2007 and December 2016, including patients with LG-MALT treated in the gastroenterology departments of Sahloul hospital in Sousse and Habib Bougtafa hospital in Bizerte, and having received treatment for eradication of HP. Results: Sixty-three patients were included. The male/female sex ratio was 1.42. The average age was 58 years. The symptomatology was dominated by epigastric pain (96.8%). On digestive endoscopy, the most frequent location and appearance were gastric antrum (39.6%) and ulcerations (89%). The lymphoma was classified as stage IE and IIE1 in 81% and 19% of cases, respectively. The HP status was positive in all patients. The HP eradication rate was 82.5% after three anti-HP treatment courses. Complete remission of lymphoma was obtained in 81% of patients at 18 months. Non-response to HP eradication therapy was observed in 19% of patients. Non-responder patients had a longer diagnostic delay (p=0.02), more diffuse endoscopic involvement (p=0.001) and a more frequent appearance of large gastric folds (p=0.001). Conclusion: The course of LG-MALT is determined by the treatment for the eradication of HP. Its success promotes remission of lymphoma.