Title: Endoscopic Morphology of Gastric MALT Lymphoma Correlate with API2/MALT1
Fusion and Predict Treatment Response After Helicobacter pylori Eradication
Version: 3 Date: 15 Oct 2024
Reviewer's report:
The logic leading to the Conclusion within the Abstract appears incomplete. To ensure a more
cohesive flow toward the Conclusion, the authors may consider making several adjustments to
clarify the progression from the research background, through methods and findings, to a well-
supported conclusion. Below is an example of a revised version with improved connections
between sections and some grammatical corrections. Note: This example is provided as a
reference; the authors should carefully examine and revise the content to align with the actual
analysis results.
Abstract
Background: The presence of API2/MALT1 fusion in gastric mucosa-associated lymphoid
tissue (MALT) lymphoma predicts poor response to Helicobacter pylori (Hp) eradication
therapy. This study aimed to assess the correlation between the endoscopic morphology of
MALT lymphoma and API2/MALT1 fusion and evaluate treatment responses to Hp eradication
based on morphological subtypes.
Methods: A retrospective review was conducted on patients diagnosed with gastric MALT
lymphoma between January 2011 and December 2022. Endoscopic morphology was categorized
as superficial, non-superficial, or mixed type. The superficial type was further classified into
gastritis superficial lesion and localized superficial lesion based on border clarity. Logistic
regression models evaluated the impact of clinical and endoscopic characteristics on anti-Hp
therapy effectiveness.
Results: Among the 114 patients included, 93 (81.6%) were Hp-positive, and API2/MALT1
fusion was detected in 58 (50.9%) cases. The regular arrangement of collecting venules (RAC)
sign was noted in 21 (18.4%) cases. API2/MALT1 fusion was more common in localized
superficial lesions than in gastritis superficial lesions (66.7% vs. 32.1%, p=0.01). Following
Hp eradication, the remission rate for localized lesions was 34.3%, significantly lower than for
gastritis lesions (66.7%, p=0.01). Both endoscopic morphology (OR=0.26, 95% CI 0.09–0.75)
and API2/MALT1 fusion (OR=14.29, 95% CI 4.19–48.67) impacted the efficacy of anti-Hp
therapy. However, multivariate analysis identified API2/MALT1 fusion as the only independent
predictor of treatment outcome (OR=12.18, 95% CI 3.49–42.55, p<0.001).
Conclusion: Gastric MALT lymphomas with superficial-type morphology, particularly those
with defined borders resembling early gastric cancer, were associated with API2/MALT1
fusion and a lower remission rate after Hp eradication therapy. This suggests that endoscopic
morphology, along with API2/MALT1 fusion status, could help predict the therapeutic response,
with API2/MALT1 fusion serving as a critical indicator of treatment resistance.
Title: Endoscopic Morphology of Gastric MALT Lymphoma Correlate with API2/MALT1
Fusion and Predict Treatment Response After Helicobacter pylori Eradication
Version: 3 Date: 15 Oct 2024
Reviewer's report:
The logic leading to the Conclusion within the Abstract appears incomplete. To ensure a more
cohesive flow toward the Conclusion, the authors may consider making several adjustments to
clarify the progression from the research background, through methods and findings, to a well-
supported conclusion. Below is an example of a revised version with improved connections
between sections and some grammatical corrections. Note: This example is provided as a
reference; the authors should carefully examine and revise the content to align with the actual
analysis results.
Abstract
Background: The presence of API2/MALT1 fusion in gastric mucosa-associated lymphoid
tissue (MALT) lymphoma predicts poor response to Helicobacter pylori (Hp) eradication
therapy. This study aimed to assess the correlation between the endoscopic morphology of
MALT lymphoma and API2/MALT1 fusion and evaluate treatment responses to Hp eradication
based on morphological subtypes.
Methods: A retrospective review was conducted on patients diagnosed with gastric MALT
lymphoma between January 2011 and December 2022. Endoscopic morphology was categorized
as superficial, non-superficial, or mixed type. The superficial type was further classified into
gastritis superficial lesion and localized superficial lesion based on border clarity. Logistic
regression models evaluated the impact of clinical and endoscopic characteristics on anti-Hp
therapy effectiveness.
Results: Among the 114 patients included, 93 (81.6%) were Hp-positive, and API2/MALT1
fusion was detected in 58 (50.9%) cases. The regular arrangement of collecting venules (RAC)
sign was noted in 21 (18.4%) cases. API2/MALT1 fusion was more common in localized
superficial lesions than in gastritis superficial lesions (66.7% vs. 32.1%, p=0.01). Following
Hp eradication, the remission rate for localized lesions was 34.3%, significantly lower than for
gastritis lesions (66.7%, p=0.01). Both endoscopic morphology (OR=0.26, 95% CI 0.09–0.75)
and API2/MALT1 fusion (OR=14.29, 95% CI 4.19–48.67) impacted the efficacy of anti-Hp
therapy. However, multivariate analysis identified API2/MALT1 fusion as the only independent
predictor of treatment outcome (OR=12.18, 95% CI 3.49–42.55, p<0.001).
Conclusion: Gastric MALT lymphomas with superficial-type morphology, particularly those
with defined borders resembling early gastric cancer, were associated with API2/MALT1
fusion and a lower remission rate after Hp eradication therapy. This suggests that endoscopic
morphology, along with API2/MALT1 fusion status, could help predict the therapeutic response,
with API2/MALT1 fusion serving as a critical indicator of treatment resistance.
Please review this paper.
user
Title: Endoscopic Morphology of Gastric MALT Lymphoma Correlate with API2/MALT1
Fusion and Predict Treatment Response After Helicobacter pylori Eradication
Version: 3 Date: 15 Oct 2024
Reviewer's report:
The logic leading to the Conclusion within the Abstract appears incomplete. To ensure a more
cohesive flow toward the Conclusion, the authors may consider making several adjustments to
clarify the progression from the research background, through methods and findings, to a well-
supported conclusion. Below is an example of a revised version with improved connections
between sections and some grammatical corrections. Note: This example is provided as a
reference; the authors should carefully examine and revise the content to align with the actual
analysis results.
Abstract
Background: The presence of API2/MALT1 fusion in gastric mucosa-associated lymphoid
tissue (MALT) lymphoma predicts poor response to Helicobacter pylori (Hp) eradication
therapy. This study aimed to assess the correlation between the endoscopic morphology of
MALT lymphoma and API2/MALT1 fusion and evaluate treatment responses to Hp eradication
based on morphological subtypes.
Methods: A retrospective review was conducted on patients diagnosed with gastric MALT
lymphoma between January 2011 and December 2022. Endoscopic morphology was categorized
as superficial, non-superficial, or mixed type. The superficial type was further classified into
gastritis superficial lesion and localized superficial lesion based on border clarity. Logistic
regression models evaluated the impact of clinical and endoscopic characteristics on anti-Hp
therapy effectiveness.
Results: Among the 114 patients included, 93 (81.6%) were Hp-positive, and API2/MALT1
fusion was detected in 58 (50.9%) cases. The regular arrangement of collecting venules (RAC)
sign was noted in 21 (18.4%) cases. API2/MALT1 fusion was more common in localized
superficial lesions than in gastritis superficial lesions (66.7% vs. 32.1%, p=0.01). Following
Hp eradication, the remission rate for localized lesions was 34.3%, significantly lower than for
gastritis lesions (66.7%, p=0.01). Both endoscopic morphology (OR=0.26, 95% CI 0.09–0.75)
and API2/MALT1 fusion (OR=14.29, 95% CI 4.19–48.67) impacted the efficacy of anti-Hp
therapy. However, multivariate analysis identified API2/MALT1 fusion as the only independent
predictor of treatment outcome (OR=12.18, 95% CI 3.49–42.55, p<0.001).
Conclusion: Gastric MALT lymphomas with superficial-type morphology, particularly those
with defined borders resembling early gastric cancer, were associated with API2/MALT1
fusion and a lower remission rate after Hp eradication therapy. This suggests that endoscopic
morphology, along with API2/MALT1 fusion status, could help predict the therapeutic response,
with API2/MALT1 fusion serving as a critical indicator of treatment resistance.
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