40例早期胃外黏膜相关淋巴组织淋巴瘤的治疗结果

目的 分析胃外黏膜相关淋巴组织(MALT)淋巴瘤的临床特征和预后.方法 回顾性分析40例首程治疗的Ⅰ_E～Ⅱ_E期原发胃外MALT淋巴瘤,其中男女比例为1:2,中位年龄54岁.原发病部位为肠道10例,眼附属器9例,甲状腺8例,肺5例,韦氏环2例及其他部位6例.Ⅰ_E期27例,Ⅱ_E期13.17例患者接受放疗(其中7例合并化疗),18例接受化疗(未合并放疗),5例单纯手术切除.结果 中位随访58个月.5年总生存率和无进展生存率分别为86%和82%.Ⅰ_E期和Ⅱ_E期5年总生存率分别为92%和76%(χ~23.66,P=0.060),无进展生存率分别为85%和76%(χ~2=1.04,P=0.300).原发眼附属器MALT淋巴瘤的5年总生存率和无进展生存率均为100%.17例接受放疗的患者无局部区域复发,局部区域控制率为100%,而23例未接受放疗者局部区域复发率为13%(3例).结论 Ⅰ_E期胃外MALT淋巴瘤可取得较好的治疗效果,放疗仍是标准治疗手段,原发眼附属器MALT淋巴瘤预后最好.

Treatment outcome of 40 patients with early stage nongastric mucosa-associated lymphoid tissue lymphoma

Objective To analyze the clinical features and prognosis of patients with stage Ⅰ_E/Ⅱ_Enongastric mucosa-associated lymphoid tissue (MALT) lymphoma. Methods Between 2000 and 2006, 40 patients with previously untreated nongrastric MALT lymphoma were retrospectively reviewed. The primary site of lymphoma was the intestinal tract in 10 patients, the orbit in 9, the thyroid in 8, the lung in 5, the Waldeyer ring in 2, and the others organs in6. At diagnosis, 27 patients had stage Ⅰ_E, and 13 had stage Ⅱ_E disease. Seventeen patients were treated with radiotherapy with or without chemotherapy, 18 with chemotherapy without radiotherapy, and 5 with surgery alone. The median age was 54 years. The ratio of male to female was 2: 1. Results With a median follow-up of 58 months, the estimated 5-year overall survival (OS) rate and progression-free survival (PFS) rate were 86% and 82%, respectively. The 5-year OS and PFS rates were 92% and 85% for stage Ⅰ_E, 76% and 82% for stage Ⅱ_E disease, respectively (χ~2 =3.66,P =0. 060;χ~2 =1.04,P=0. 300). The 5-year OS and PFS rates were both 100% for patients with MALT lymphoma of the orbit and ocular adnexa. None of the 17 patients with radiotherapy had locoregional relapse, whereas 3 of 23 (13%) patients without radiotherapy had locoregional relapse. Conclusions Patients with stage Ⅰ_E nongastric MALT lymphoma have a favorable prognosis. Radiotherapy is still a standard care for early stage disease. The treatment outcome of patients with MALT lymphoma of the orbit and ocular adnexa is even better.