Chapters authored
Splenectomy in Gastric Cancer: Influence of B Lymphocytes
The spleen is the largest peripheral organ of the immune system. The standard volume of lymphodissection in stomach cancer during gastrectomy or proximal resection is D2, which implies splenectomy. Immunity disorders in patients after splenectomy primarily affect the B cell immune response. Peripheral blood B-lymphocytes subpopulations have been studied in patients with gastric cancer. Group 1 - patients with gastrectomy, D2 lymphodissection, group 2 - patients with gastrectomy, D2-lymphodissection, splenectomy. Evaluation of the expression of antigens (CD20, CD21, CD23, CD38, HLA-DR, CD71, CD10, CD95, CD25, CD5, CD56, κ- and λ-light was performed in the gate of CD19+ cells. Among peripheral blood lymphocytes the presence of CD19+CD5+ B cells (B1a cells), some of which express the activation antigens CD38 and CD23 is found; a small part of CD5+ B cells is CD25+CD38−. The number of CD23+ cells ranged from 25 to 40% in different patients. A significant number of B cells with a low level of CD21+ expression were detected. In group 2 after surgery, the percentage of cells with CD5+ expression significantly increased, the relative amount of CD19+ lymphocytes, CD19+CD21+ B cells decreased. Given data on B1 and BMZ populations, this can lead to a weakening of both general and antitumor immunity.
Part of the book: Normal and Malignant B-Cell
MALT Stomach Lymphomas: Aspects of Diagnosis and Treatment
Marginal zone lymphoma (LMZ) accounts for 5–15% of all NHL in Europe. This option includes splenic (0.7%), nodal (2.4%) and extranodal (MALT-Mucosa-Associated Limphoid-Tissue) LMZ −5%. Extranodal variants of MALT lymphomas can occur in any organ due to chronic antigenic stimulation. The most frequent localization associated with Helicobacter pylori (Hp) infection is the stomach - 30%. The gastrobiopsy material of 115 patients with lymphoid cell infiltrates in the gastric mucosa was studied, a complex of morphological diagnostic criteria for MALT gastric lymphoma for gastrobiopsy was developed based on a combination of histological and immunohistochemical characteristics of tumor cells, the nature of their growth. It is known that the mandatory initial therapy for local stages of Hp-positive MALT lymphoma of the stomach is the eradication of Hp. 68 patients with stages I – II of gastric MALT lymphomas were observed. Anti Hp therapy resulted in 87.8% of complete remissions, with a median duration of 51 months. The median time to the onset of Hp-eradication was 3 months, and the median time to the implementation of the antitumor process was 5.5 months. With a median follow-up of 58 months, the median overall and relapse-free survival was not achieved: 10-year OS - 100%, 10-year RFS - 92. 3%.
Part of the book: Helicobacter pylori