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The aim of this study was to investigate the Lewis antigen expression in  Helicobacter pylori  gastric MALT lymphoma associated strains in comparison to chronic gastritis only strains. Forty MALT strains (19  cag PAI (−) and 21  cag PAI (+)) and 39  cag PAI frequency-matched gastritis strains (17  cag PAI (−) and 22  cag PAI (+)) were included in this study. The lipopolyssacharide for each strain was extracted using a hot phenol method and the expression of Le x  and Le y  were investigated using Western Blot. The data were analyzed according to the strains'  cag PAI status and  vac A genotype. Le x  was identified in 21 (52.5%) MALT strains and 29 (74.3%) gastritis strains. Le y  was identified in 30 (75%) MALT strains and 31 (79.5%) gastritis strains. There was an association between  cag PAI positivity and Le x  expression among MALT strains ( p <0.0001), but not in gastritis strains ( p  = 0.64). Among  cag PAI (−) strains, isolates expressing solely Le y  were associated with MALT with an odds ratio of 64.2 (95% CI 4.9–841.0) when compared to strains expressing both Le x  and Le y .  vac A genotypes did not modify the association between Lewis antigen expression and disease status. In conclusion,  cag PAI (−) MALT strains have a particular Lewis antigen profile which could represent an adaptive mechanism to the host response or participate in MALT lymphomagenesis.

Is There a Link between the Lipopolysaccharide of Helicobacter pylori Gastric MALT Lymphoma Associated Strains and Lymphoma Pathogenesis?