Involvement of Helicobacter Pylori in Ocular Adnexa Lymphoma
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REVIEW
Involvement of Helicobacter Pylori in Ocular Adnexa Lymphoma Antonio Travaglino 1 & Mirella Pace 1 & Silvia Varricchio 1 & Daniela Russo 1 & Novella Pugliese 2 & Alessandro Severino 2 & Marco Picardi 2 & Fabrizio Pane 2 & Luigi Insabato 1 & Stefania Staibano 1 & Massimo Mascolo 1 Received: 3 July 2019 / Accepted: 11 June 2020 # Arányi Lajos Foundation 2020
Abstract Helicobacter pylori has been proposed as a possible etiologic factor of ocular adnexa lymphoma (OAL), although with conflicting results. To assess the involvement of H. pylori in OAL, as (1) H. pylori DNA positivity on OAL specimens, and (2) prevalence of H. pylori gastric infection in patients with OAL. A systematic review of studies assessing H. pylori in patients with OAL was conducted by searching electronic databases from their inception to May 2019. Pooled positivity for H. pylori in OAL specimens detected by polymerase chain reaction, and pooled prevalence of H. pylori gastric infection, were calculated with 95% confidence interval (CI). Eleven studies with 308 patients were included. Pooled positivity for H. pylori was 16.8% in all OALs and 22.7% in MALT OAL, with high heterogeneity among studies. Pooled prevalence of H. pylori gastric infection in patients with OAL was 34.7%, with low statistical heterogeneity. In conclusion, H. pylori seems to be involved in a subset of OAL, but the heterogeneity found needs to be investigated in further studies. The prevalence of H. pylori gastric infection in patients with OAL does not seem to differ from that of the general population. Keywords Orbit . Ocular adnexa . Lymphoma . Helicobacter pylori . Antibiotic . Extranodal
Introduction Ocular adnexal lymphoma (OAL) accounts for 5–15% of all extranodal lymphomas. In 60–80% of cases, OAL is a mucosa associated lymphoid tissue (MALT) lymphoma [1–3]. Several possible etiopathogenetic factors have been hypothesized for OAL, with a particular emphasis for chronic infections [1–4]. The main infectious agents studied have been bacteria of the Chlamydia genus (in particular C. psittaci), hepatitis viruses and Helicobacter pylori [4–15]. The importance of the identification of an etiologic infectious agent lies in the possibility of using targeted antibiotic therapies to eradicate the lymphoma [7, 8, 15–17]. The best example in this Electronic supplementary material The online version of this article (https://doi.org/10.1007/s12253-020-00848-6) contains supplementary material, which is available to authorized users. * Massimo Mascolo [email protected] 1
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field is gastric MALT lymphoma, in which antibiotics against H. pylori are considered as the first-line treatment [18]. In this review, we focused on the involvement of H. pylori in OALs. Given the contrasting results about a possible etiopathogenetic role of H. pylori in OAL [5–15], we aimed to define whether such role can reasonably be hypothesized. For this purpose, we planned a systematic review and metaanalysis to quantify both the presence of H. pylori in OAL specimens and the prevalence of H. pylo
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