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MALT lymphomas show different behaviour and clinical outcomes depending on their primary location 标题：不同初发部位的MALT淋巴瘤的生物学行为和临床预后也不同 作者：Mei-Kim Ang, M Tao, R Quek, I Sng, L Tan, S T Lim Background Mucosa-associated lymphoid tissue (MALT) lymphomas are the most common subtype of marginal-zone lymphomas. There is limited data available regarding clinical and biological prognostic markers, and few studies on treatment involving chemotherapy, radiotherapy, or surgery, making therapeutic decision-making difficult. Moreover, the data published to date are mainly from western populations. The aim of this study is to examine the clinicopathological features of MALT lymphoma and to correlate this with treatment and clinical outcomes in an Asian population. 研究背景：粘膜相关淋巴组织（MALT）淋巴瘤是边缘带淋巴瘤中最常见的亚型，与之相关的临床和生物学预后标志物的资料有限，囊括化疗、放疗或手术治疗方面的研究很少，这使得制定治疗方案困难。然而，至今公开的资料主要来自西方人群。本研究的目的是研究亚洲人群MALT淋巴瘤的临床病理学特征及其与治疗和临床预后相关性。 Methods A retrospective review was conducted for all patients with a histological diagnosis of MALT lymphoma treated at our institution from January, 2000, to November, 2006. 方法：对2000年1月至2006年11月期间、组织学诊断为MALT淋巴瘤、在我们科治疗的所有患者进行了回顾性分析。 Findings 146 patients with MALT lymphoma were identified; the two most common sites were gastric (30%) and orbital (20%). Preliminary comparison of these two subsets of MALT lymphoma showed the median age was 63 years and 49 years for gastric and orbital lymphomas, respectively, with 20% of patients with orbital lymphoma over the age of 60 years compared with 59% of patients with gastric lymphomas. Although both groups had a similar proportion of patients with early stage disease (87% vs 88% in gastric and orbital groups, respectively), and no bone marrow involvement (97% vs 96% in gastric and orbital groups, respectively), there was a much higher rate of high grade transformation in the gastric group compared with the orbital group (33% vs 0%). Overall survival was 100% in the orbital lymphoma group compared with 79% in the gastric lymphoma group. 结果：共确诊146例MALT淋巴瘤，最常见的两个部位是胃（30%）、眼眶（20%）。对两类MALT淋巴瘤进行初步比较后显示：胃淋巴瘤和眼眶淋巴瘤患者的平均年龄分别为63岁、49岁;年龄超过60岁的患者，眼眶淋巴瘤中占20%、而胃淋巴瘤中占59%。虽然两组中有相似的早期患者人数比例（胃组87%、眼眶组88%）和无骨髓侵犯比例（胃组97%、眼眶组96%），但是向高度恶性转化的比例胃组较眼眶组更高（33%比0%）。总生存率眼眶淋巴瘤组为100%、胃淋巴瘤组为79%。 Interpretation Our preliminary data show that there is marked heterogeneity among different subsets of MALT lymphoma with a higher proportion of high-grade transformation and poorer overall survival in gastric MALT lymphoma compared with orbital MALT lymphoma. Our results for gastric MALT lymphoma show a much higher rate of histological transformation to large-cell lymphoma at diagnosis than previously reported. Further detailed analyses of pathological features and other subsets of MALT lymphoma will be done to correlate the above findings. 结果解读：研究初步资料表明MALT淋巴瘤的不同亚类之间有明显的异质性，与眼眶MALT淋巴瘤相比，胃MALT淋巴瘤向高度恶性转化的比例更高、总生存率更差。与以前的报道相比，我们的结果表明胃MALT淋巴瘤在诊断时组织学转化为大细胞淋巴瘤的比例更高。进一步详细分析MALT淋巴瘤的病理特征及其它亚类会得出与上述结果关联。 编译： （658字） 新加坡国家癌症中心肿瘤医学系Mei-Kim Ang等学者在2007年4月22日新加坡召开的《柳叶刀亚洲医学论坛》上报道了他们的一项有关粘膜相关淋巴组织（MALT）淋巴瘤的回顾性分析结果，认为MALT淋巴瘤的生物学行为和临床预后与初发部位有关。 MALT淋巴瘤是边缘带淋巴瘤中最常见的亚型，与之相关的临床和生物学预后标志物的资料有限，囊括化疗、放疗或手术治疗方面的研究很少，这使得制定治疗MALT淋巴瘤方案非常困难，而且至今发表的MALT淋巴瘤相关资料主要来自西方人群。作者为此设计了亚洲人群MALT淋巴瘤的临床病理学特征及其与治疗和临床预后相关性这项研究。 研究中对2000年1月至2006年11月期间、组织学诊断为MALT淋巴瘤、在新加坡国家癌症中心肿瘤医学系治疗的所有患者进行了回顾性分析。共确诊146例MALT淋巴瘤，最常见的两个部位是胃（30%）、眼眶（20%）。对两类MALT淋巴瘤进行初步比较后显示：胃淋巴瘤和眼眶淋巴瘤患者的平均年龄分别为63岁、49岁;年龄超过60岁的患者，眼眶淋巴瘤中占20%、而胃淋巴瘤中占59%。虽然两组中有相似的早期患者人数比例（胃组87%、眼眶组88%）和无骨髓侵犯比例（胃组97%、眼眶组96%），但是向高度恶性转化的比例胃组较眼眶组更高（33%比0%）。总生存率眼眶淋巴瘤组为100%、胃淋巴瘤组为79%。 基于上述结果，作者认为MALT淋巴瘤的不同亚类之间有明显的异质性，与眼眶MALT淋巴瘤相比，胃MALT淋巴瘤向高度恶性转化的比例更高、总生存率更差;与以前的报道结果相比，胃MALT淋巴瘤在诊断时组织学转化为大细胞淋巴瘤的比例更高;进一步详细分析MALT淋巴瘤的病理特征及其它亚类会得出与上述结果关联。 |
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