Clinical characteristics, diagnosis, treatment, and prognostic factors of pulmonary mucosa-associated lymphoid tissue-derived lymphoma
Clinical characteristics, diagnosis, treatment, and prognostic factors of pulmonary mucosa-associated lymphoid tissue-derived lymphoma
复制标题
肺粘膜相关淋巴组织源性淋巴瘤的临床特征、诊断、治疗和预后因素。
DOI：
10.1002/cam4.2683
复制
发表时间：
2019-11-05
期刊：
影响因子：
4
通讯作者：
Wang, Qun
中科院分区：
文献类型：
--
作者：
Wang, Lin;Te, Guanzhi;Wang, Qun
摘要原发性肺粘膜相关淋巴组织淋巴瘤是一种罕见的疾病，预后良好。然而，其临床特征、诊断、治疗和预后仍不清楚。我们回顾性分析了2006年至2018年病理证实的80例MALT淋巴瘤患者。记录80例患者的临床特点、诊断、治疗及预后。将患者分为手术组和活检组，评估手术在MALT淋巴瘤诊断和治疗中的作用。比较不同临床特征及治疗方法对预后的影响。病理诊断经手术、支气管镜检查及经皮活检证实。30例患者接受手术治疗。而在手术组接受手术的18例患者中，有4例MALT淋巴瘤仅通过支气管纤维镜检查或皮肤活检诊断出来。手术组辅助化疗6例，累及野放疗1例。单纯化疗31例，放疗1例，仅对症支持治疗1例，活检组17例建议等待观察，不建议治疗。随访期间死亡8例，5年生存率为87.1%。肿瘤数量、治疗和年龄是影响总生存期（OS）的预后因素，但根据多因素分析，年龄是唯一独立的预后因素。而肿瘤数量是无进展生存期（PFS）分析中唯一的预后因素。手术切除与不手术切除患者的OS或PFS无显著差异。MALT淋巴瘤是一种惰性疾病，治疗效果良好。肿瘤数量与PFS相关，年龄是肺部MALT淋巴瘤患者唯一重要的预后因素，因其惰性，但手术在MALT淋巴瘤的诊断和治疗中仍起着重要作用。
Primary pulmonary mucosa-associated lymphoid tissue-derived (MALT) lymphoma is a rare disease with a favorable prognosis. However, its clinical characteristics, diagnosis, treatment, and prognoses remain unclear. We retrospectively analyzed 80 patients with pathologically confirmed MALT lymphoma from 2006 to 2018. The clinical characteristics, diagnosis, treatments, and prognoses of all the 80 patients were recorded. Patients were stratified into surgery and biopsy groups, respectively, to evaluate the role of surgery in the diagnosis and treatment of MALT lymphoma. The prognoses were compared between different clinical characteristics and treatments. Pathological diagnoses were confirmed by surgery, bronchoscopy, and percutaneous biopsy. Thirty patients were treated by surgery. While MALT lymphoma was only diagnosed by bronchofiberoscopy or bercutaneous biopsy in four of 18 patients in the surgery group who underwent the procedure. Six patients received adjuvant chemotherapy and one patient received involved-field radiotherapy in surgery group. Thirty-one patients were treated with chemotherapy alone, one patient was treated with radiotherapy, one patient received only symptomatic and supportive treatment, and waiting and watching without treatment were recommended in 17 patients in biopsy group. Eight patients died during follow-up and the 5-year survival rate was 87.1%. Tumor number, treatment, and age were prognostic factors for overall survival (OS), but age was the only independent prognostic factor according to multivariate analysis. While, tumor number was the only prognostic factor in the analysis about progression-free survival (PFS). No significant difference was found in OS or PFS between patients treated with and without surgical resection. MALT lymphoma is an indolent disease with favorable treatment outcome. Tumor number is associated with PFS and age is the only significant prognostic factor for pulmonary MALT lymphoma patients because of its indolent nature, but surgery still plays an important role in the diagnosis and treatment of MALT lymphoma.