Clinical features and prognosis of mucosa-associated lymphoid tissue lymphoma

目的 探讨黏膜相关淋巴组织(MALT)淋巴瘤的临床特点和治疗方法.方法 回顾性分析2000年9月至2012年11月北京肿瘤医院80例MALT淋巴瘤患者的临床资料,按原发部位分为胃组和非胃组进行分析.结果 80例患者中胃组32例(40.0％),非胃组48例(60.0％).两组比较,胃组患者易出现贫血[50.0％ (16/32)比25.0％ (12/48),P=0.022]；非胃组患者Ⅲ～Ⅳ期比例高于胃组[35.4％ (17/48)比12.5％(4/32),P=0.022].中位随访30个月,5年总体生存(OS)率为90.0％,5年无进展生存(PFS)率为67.0％.非胃组Ⅲ～Ⅳ期手术联合化疗组3年PFS率优于单独手术组(83.0％比33.0％),中位PFS期分别为43.4个月和20.3个月(P =0.040).初治选择化疗者含利妥昔单抗组和单纯化疗组5年OS率分别为100.0％和86.0％(P=0.106).多因素分析中初始疗效(OR=0.258,P=0.020)和白蛋白减低(OR=3.967,P=0.009)是PFS独立预后因素.结论 非胃MALT淋巴瘤进展期较常见,进展期患者可考虑全身治疗；胃MALT淋巴瘤手术治疗易残留.To explore the clinical features and treatments of mucosa-associated lymphoid tissue (MALT) lymphoma.The clinical data of 80 MALT lymphoma patients treated from September 2000 to November 2012 were retrospectively analyzed.Among them, 32 (40.0%) had gastric MALT lymphoma and 48(60.0%) non-gastric MALT lymphoma. Gastric lymphoma associated anemia accounted for 50.0% (16/32) (25.0% (12/48) in non-gastric group, P = 0.022). In non-gastric group, stage III-IV diseases accounted for 35.4% (17/48) (12.5% (4/32) in gastric group, P = 0.022). During a median follow-up of 30 months, the 5-year overall survival (OS) rate was 90.0% and 5-year progression-free survival (PFS) rate 67.0%. For the non-gastric group, surgery plus chemotherapy group was superior in PFS to surgery alone group (the 3-year PFS rate 83.0% and 33.0%; median PFS 43.4 months and 20.3 months) (P = 0.040). Five-year OS in patients on first-line rituximab and chemotherapy without rituximab were 100.0% and 86.0% respectively (P = 0.106). Short-term response (OR = 0.258, P = 0.020) and low albumin (OR = 3.967, P = 0.009) were independent factor for PFS.Non-gastric MALT lymphoma is easily disseminated. Systemic treatment may be considered for advanced non-gastric MALT lymphoma. Surgery often leaves residual lesions for gastric MALT lymphoma.PubMed中文核心期刊要目总览(PKU)中国科技核心期刊(ISTIC)中国科学引文数据库(CSCD)010759-7629