Clinical implications of nodal marginal zone B-cell lymphoma among Japanese: study of 65 cases
Clinical implications of nodal marginal zone B-cell lymphoma among Japanese: study of 65 cases
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DOI：
10.1111/j.1349-7006.2006.00345.x
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发表时间：
2007-01-01
期刊：
影响因子：
5.7
通讯作者：
Nakamura, Shigeo
中科院分区：
文献类型：
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作者：
Kojima, Masaru;Inagaki, Hiroshi;Nakamura, Shigeo
为了阐明淋巴结边缘区 B 细胞淋巴瘤 (NMZBL) 的临床表现和结果，我们对 65 名患有该疾病的日本患者进行了研究，并与西方国家已发表的文献进行了比较。我们的65例病例的临床表现在某些方面与他们的病例相似：（1）58%的患者年龄>60岁（中位年龄64岁）； (2) 女性略占优势； (3)90%的患者表现为头颈部无症状淋巴结肿大； (4)仅有少数患者出现B症状(6%)和体能状态不佳(8%)； (5) 只有 5% 的患者 M 蛋白呈阳性。然而，该系列中的65例患者比西方文献中发表的NMZBL系列表现出相对更长的5年总生存率（85%）和无失败生存率（60%），表明NMZBL应归类为惰性淋巴瘤。此外，根据组织学结果，我们进一步将其分为以下四种组织学亚型：（1）脾型（n = 7）； (2)花型(n=9)； （3）粘膜相关淋巴组织（MALT）型（n = 29）； (4) 弥漫性大 B 细胞淋巴瘤 (DLBCL) + MALT 型 (n = 20)。 DLBCL + MALT 型的 5 年总生存率明显低于脾脏型。 DLBCL + MALT 类型的识别显得很重要。在所检查的 14 例病例中，均未检测到 API2-MALT1 融合转录物。
To clarify the clinical presentation and outcome of nodal marginal zone B-cell lymphoma (NMZBL), 65 Japanese patients with this disease were studied and compared with the published literature from western countries. The clinical findings of our 65 cases were similar to those of their cases in some aspects: (1) 58% of the patients were > 60 years old (median age, 64 years); (2) there was a slight female predominance; (3) 90% of the patients exhibited asymptomatic lymphadenopathy in the head and neck area; (4) only a minority of patients had B symptoms (6%) and poor performance status (8%); and (5) only 5% of patients were positive for M-protein. However, the 65 patients in this series exhibited relatively longer 5-year overall survival (85%) and failure-free survival (60%) than the NMZBL series published in western literature, suggesting that NMZBL should be classified as indolent lymphoma. Moreover, based on the histological findings, we further classified four histological subtypes as follows: (1) splenic type (n = 7); (2) floral type (n = 9); (3) mucosa-associated lymphoid tissue (MALT) type (n = 29); and (4) diffuse large B-cell lymphoma (DLBCL) + MALT type (n = 20). DLBCL + MALT type exhibited significantly poorer 5-year overall survival than the splenic variant. The recognition of DLBCL + MALT type appears important. No API2-MALT1 fusion transcript was detected in any of the 14 cases examined.