CAJ | 학술논문

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.
목적 탐토점막상관림파조직(MALT)림파류적림상특점화치료방법.방법 회고성분석2000년9월지2012년11월북경종류의원80례MALT림파류환자적림상자료,안원발부위분위위조화비위조진행분석.결과 80례환자중위조32례(40.0％),비위조48례(60.0％).량조비교,위조환자역출현빈혈[50.0％ (16/32)비25.0％ (12/48),P=0.022]；비위조환자Ⅲ～Ⅳ기비례고우위조[35.4％ (17/48)비12.5％(4/32),P=0.022].중위수방30개월,5년총체생존(OS)솔위90.0％,5년무진전생존(PFS)솔위67.0％.비위조Ⅲ～Ⅳ기수술연합화료조3년PFS솔우우단독수술조(83.0％비33.0％),중위PFS기분별위43.4개월화20.3개월(P =0.040).초치선택화료자함리타석단항조화단순화료조5년OS솔분별위100.0％화86.0％(P=0.106).다인소분석중초시료효(OR=0.258,P=0.020)화백단백감저(OR=3.967,P=0.009)시PFS독립예후인소.결론 비위MALT림파류진전기교상견,진전기환자가고필전신치료；위MALT림파류수술치료역잔류.
Objective To explore the clinical features and treatments of mucosa-associated lymphoid tissue (MALT) lymphoma.Methods The clinical data of 80 MALT lymphoma patients treated from September 2000 to November 2012 were retrospectively analyzed.Results 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.Conclusions Nongastric MALT lymphoma is easily disseminated.Systemic treatment may be considered for advanced nongastric MALT lymphoma.Surgery often leaves residual lesions for gastric MALT lymphoma.