中华血液学杂志
中華血液學雜誌
중화혈액학잡지
Chinese Journal of Hematology
2015年
1期
24-28
,共5页
赵夏%王黎%张晟婷%王舒蓓%孙蕴伟%赵维莅
趙夏%王黎%張晟婷%王舒蓓%孫蘊偉%趙維蒞
조하%왕려%장성정%왕서배%손온위%조유리
淋巴瘤,B细胞,边缘区%生物医学研究%预后
淋巴瘤,B細胞,邊緣區%生物醫學研究%預後
림파류,B세포,변연구%생물의학연구%예후
Lymphoma,B-cell,marginal zone%Biomedical research%Prognosis
目的 了解原发胃肠道黏膜相关淋巴组织结外边缘区B细胞淋巴瘤(MALT淋巴瘤)患者临床特征及预后情况.方法 回顾性分析90例原发胃肠道MALT淋巴瘤患者资料,对患者临床特征和相关预后因素进行分析.结果 90例患者中胃内起病者78例,非胃内起病者12例.国际预后指数(IPI)评分0～2分者80例,3～5分者10例.与胃内起病者比较,非胃内起病者多为IPI 3～5分的高危患者(7.7％对33.3％,P=0.025)、幽门螺旋杆菌(Hp)感染率显著降低(50.0％对87.2％,P＜0.01).IPI评分0～2分的低危患者可选择抗Hp治疗、手术、放疗及化疗等治疗,其中化疗可提高患者无进展生存(PFS)率.接受化疗的高危患者3年总生存(OS)率达100.0％.单因素分析结果显示,ECOG评分(P=0.006)、Musshoff分期(P=0.008)、IPI评分(P=0.000)、LDH水平(P=0.019)和是否接受化疗(P=0.026)是影响患者PFS率的相关因素.多因素分析结果显示IPI评分(3～5分)(OR=8.325,95％ CI 3.171～21.853,P=0.000)和是否接受化疗(OR=0.319,95％CI0.121～0.838,P=0.020)是影响患者PFS率的独立预后因素,ECOG评分(≥2分)是影响患者OS率的独立预后因素(OR=5.092,95％CI1.005～25.788,P=0.049).结论 原发胃肠道MALT淋巴瘤是一种低度恶性的淋巴瘤,以低危患者多见,多数患者可获得长期生存.低危患者可选择放疗或抗Hp治疗作为起始治疗方案,高危患者应选择化疗.
目的 瞭解原髮胃腸道黏膜相關淋巴組織結外邊緣區B細胞淋巴瘤(MALT淋巴瘤)患者臨床特徵及預後情況.方法 迴顧性分析90例原髮胃腸道MALT淋巴瘤患者資料,對患者臨床特徵和相關預後因素進行分析.結果 90例患者中胃內起病者78例,非胃內起病者12例.國際預後指數(IPI)評分0～2分者80例,3～5分者10例.與胃內起病者比較,非胃內起病者多為IPI 3～5分的高危患者(7.7％對33.3％,P=0.025)、幽門螺鏇桿菌(Hp)感染率顯著降低(50.0％對87.2％,P＜0.01).IPI評分0～2分的低危患者可選擇抗Hp治療、手術、放療及化療等治療,其中化療可提高患者無進展生存(PFS)率.接受化療的高危患者3年總生存(OS)率達100.0％.單因素分析結果顯示,ECOG評分(P=0.006)、Musshoff分期(P=0.008)、IPI評分(P=0.000)、LDH水平(P=0.019)和是否接受化療(P=0.026)是影響患者PFS率的相關因素.多因素分析結果顯示IPI評分(3～5分)(OR=8.325,95％ CI 3.171～21.853,P=0.000)和是否接受化療(OR=0.319,95％CI0.121～0.838,P=0.020)是影響患者PFS率的獨立預後因素,ECOG評分(≥2分)是影響患者OS率的獨立預後因素(OR=5.092,95％CI1.005～25.788,P=0.049).結論 原髮胃腸道MALT淋巴瘤是一種低度噁性的淋巴瘤,以低危患者多見,多數患者可穫得長期生存.低危患者可選擇放療或抗Hp治療作為起始治療方案,高危患者應選擇化療.
목적 료해원발위장도점막상관림파조직결외변연구B세포림파류(MALT림파류)환자림상특정급예후정황.방법 회고성분석90례원발위장도MALT림파류환자자료,대환자림상특정화상관예후인소진행분석.결과 90례환자중위내기병자78례,비위내기병자12례.국제예후지수(IPI)평분0～2분자80례,3～5분자10례.여위내기병자비교,비위내기병자다위IPI 3～5분적고위환자(7.7％대33.3％,P=0.025)、유문라선간균(Hp)감염솔현저강저(50.0％대87.2％,P＜0.01).IPI평분0～2분적저위환자가선택항Hp치료、수술、방료급화료등치료,기중화료가제고환자무진전생존(PFS)솔.접수화료적고위환자3년총생존(OS)솔체100.0％.단인소분석결과현시,ECOG평분(P=0.006)、Musshoff분기(P=0.008)、IPI평분(P=0.000)、LDH수평(P=0.019)화시부접수화료(P=0.026)시영향환자PFS솔적상관인소.다인소분석결과현시IPI평분(3～5분)(OR=8.325,95％ CI 3.171～21.853,P=0.000)화시부접수화료(OR=0.319,95％CI0.121～0.838,P=0.020)시영향환자PFS솔적독립예후인소,ECOG평분(≥2분)시영향환자OS솔적독립예후인소(OR=5.092,95％CI1.005～25.788,P=0.049).결론 원발위장도MALT림파류시일충저도악성적림파류,이저위환자다견,다수환자가획득장기생존.저위환자가선택방료혹항Hp치료작위기시치료방안,고위환자응선택화료.
Objective To evaluate the clinical characteristics and prognostic factors of patients with primary gastro-intestinal marginal zone lymphoma (MALT).Methods Retrospective aualysis was performed in 90 patients diagnosed with primary gastro-intestinal MALT lymphoma clinical characteristics and survival analyses.Results Among 90 patients,78 cases were originated from the stomach and 12 cases with extra-gastric origin.Eighty patients were classified as low-risk (IPI score 0-2),and 10 patients high-risk (IPI score 3-5).Compared to gastric MALT patients,extra-gastric cases presented with higher IPI score (7.7％ vs 33.3％,P=0.025) and higher Hp infection rate (50.0％ vs 87.2％,P＜0.01).Treatment options for low risk patients (IPI score 0-2) included Hp eradication,surgery,radiotherapy and chemotherapy.Chemotherapy could improve progression-free survival (PFS) in low-risk patients.For high-risk patients,those receiving chemotherapy had 100％ 3-year overall survival (OS).Univariate analysis revealed that ECOG (P=0.006),Musshoff staging (P=0.008),IPI score (P=0.000),elevated LDH (P=0.019) and chemotherapy (P=0.026) were correlated with PFS.Multivariate analysis showed that higher IPI score (IPI 3-5) (OR=8.325,95％ CI 3.171-21.853,P=0.000) and chemotherapy (OR=0.319,95％ CI 0.121-0.838,P=0.020) were independent prognostic factors for PFS.ECOG (≥2) was independent prognostic factor for OS(OR=5.092,95％CI 1.005-25.788,P=0.049).Conclusion Primary gastro-intestinal MALT lymphoma was an indolent subtype of non-Hodgkin' s lymphoma.Patients usually had low risk IPI and achieved long-term survival.Frontline therapy for low-risk patients was radiotherapy or Hp eradication,and chemotherapy for high-risk ones.
