8041 Background: Long lasting remissions occur in most patients with localized GML after Hp eradication. Ongoing B-cell clonality and the translocation t(11;18) have been described as factors associated with no response, relapse and histological residual disease (hRD). Systematic evaluation of histological findings associated with the clinical course and molecular data has not been described yet. Methods: Detailed analysis of long term follow up data of a prospective multicenter trial including 120 patients (median follow up > 5 years) with Hp-positive stage I1E GML was performed. Histological and molecular data of biopsies from 1187 endoscopies were analyzed using a large data base. Hp-status, granulocytic-, lymphocytic infiltration and intestinal metaplasia (IM) were histologically graduated according to the Updated Sydney system. The histological findings empty lamina propria (ELP), fibrosis, lymphoid follicles (LF) and lymphoepithelial lesions and lymphoid aggregates (LA) were evaluated. Prospective molecular data concerning B-cell clonality as well as retrospective data concerning the status of the translocation t(11;18) were also collected. Results: LA and LF were more present in patients not responding towards Hp eradication [P < 0.0001]. ELP in high frequency is a positive predictor for reaching complete remission (CR) [P= <0,0001]. Fibrosis was only found in CR patients. In patients reaching a histological CR presence of LA and LF were associated with hRD and relapse [P=0.04]. LA / LF were also more prevalent in t(11;18) positive and patients with ongoing B-cell clonality. An association between ongoing monoclonality and t (11;18) was also demonstrated [p=0,012]. In 66% of patients IM was detected, it does not disappear during long term follow up after successful Hp eradication. Conclusions: Simple histological findings can help to predict the clinical course of GML after Hp eradication and are associated with known molecular data. No significant financial relationships to disclose.
A prospective, multicenter trial of a long-term bioabsorbable mesh with sepra technology in cohort of challenging laparoscopic ventral or incisional hernia repairs (ATLAS trial)
