103例胃黏膜相关淋巴组织淋巴瘤患者的临床特点和预后分析  

The clinical characteristics and prognostic analysis of gastric mucosa-associated lymphoid tissue lym. phoma of 103 cases

作　　者：李晓武[1] 夏冰[1] 郭青[1] 晋鑫[1] 于泳[1] 赵智刚[1] 王晓芳[1] 王亚非[1] 张翼鷟[1] 

机构地区：[1]天津医科大学附属肿瘤医院血液科,300060

出　　处：《中华血液学杂志》2012年第10期805-809,共5页Chinese Journal of Hematology

基　　金：国家自然科学基金（30672208）;天津医科大学新世纪人才项目

摘　　要：目的探讨胃黏膜相关淋巴组织（MALT）淋巴瘤患者的临床特点和预后。方法回顾性分析我院2001年4月至2011年8月收治的103例胃MALT淋巴瘤患者资料，分析其临床特征和相关预后因素。结果患者多起病隐袭，无特异性临床表现，以腹痛、腹部不适、体重减轻、纳差、恶心、呕吐等症状为主。Musshoff分期：Ⅰ／Ⅱ期75例（72．8％），Ⅲ／Ⅳ期28例（27．2％）。非手术治疗组和手术治疗组患者的5年总生存（OS）率分别为78．9％和60．4％，两者差异无统计学意义（P=0．072）；非手术治疗组的5年无进展生存（PFS）率为52．8％，显著高于手术治疗组（31．7％），两者差异有统计学意义（P=0．023）。幽门螺杆菌（Hp）感染率91．2％，抗Hp治疗临床有效率达100％。在有完整随访资料的94例患者中，5年OS率为75％，5年PFS率为46％。预后相关分析提示：B症状、淋巴结转移、Musshoff分期、乳酸脱氢酶、β2-微球蛋白及国际预后指数评分是影响患者0s和PFS的相关因素，而Musshoff-ⅢE／ⅣE期、IPI评分〉2分、B症状是影响患者OS的独立不良因素（P〈0．05），Musshoff-ⅢE／ⅣE期是影响患者PFS的独立不良因素（P=0．027）。结论胃MALT淋巴瘤生存率高，预后良好；建议予以抗Hp治疗为主的非手术治疗，避免手术有创治疗。Musshoff-ⅢE／IVE期、B症状或IPI评分〉2分是胃MALT淋巴瘤患者的不良预后因素。Objective To analyze the clinical characteristics and prognosis of the patients with gas- tric mucosa-associated lymphoid tissue （MALT） lymphoma. Methods The clinical characteristics and prog- nostic factors of 103 gastric MALT lymphoma patients admitted to our hospital from April 2001 to August 2011 were retrospectively analyzed. Results The onset of gastric MALT lymphoma was often insidious without spe- cific clinical manifestation, the most common complaints were abdominal pain or discomfort ,weight loss, poor appetite, nausea and vomiting. According to Musshoff staging system, 75 （72.8 % ） patients were at early sta- ges （ Ⅰ /Ⅱ ） and 28 （27.2%） patients at advanced stages （Ⅲ/Ⅳ）. There was no significant difference in five-year overall survival （OS） between the patients in surgery group and non-surgery group （60.4% vs 78.9% , respectively, P =0072）, while there was statistical difference in five-year progression-free survival （PFS） between the two groups （31.7% vs 52.8%, respectively, P = O. 023）. Helicobacter pylori （Hp） was detected in 94 patients （91.2%）. Anti-Hp treatment was effective with 100% overall response rate. In 94 patients with complete follow-up data, the 5-year OS rate was 75%, 5-year PFS rate was 46%. Univariate survival analysis showed that the B symptoms, Musshoff staging, performance staging, stage-modified IPI, levels of LDH, nodal involvement and levels of [32-microglobulin were correlated with OS and PFS （P 〈 0.05）. The Cox regression analysis showed that Musshoff-m/1v stage, stage-modified IPI score 〉 2 and B symptoms were independent factor for OS （ P 〈 0.05 ）, whereas Musshoff-m/iv stage was independent factor for PFS （P = 0.027）. Conclusion The gastric MALT lymphoma had a favorable outcome with high OS rate. The anti-Hp therapy was an effective treatment for the gastric MALT lymphoma, which avoid the surgical trau- ma and improve the quality of life. The prognostic analysis showed that Musshoff staging, B symptoms

关 键 词：淋巴瘤 非霍奇金 临床研究 螺杆菌 幽门 预后 

分 类 号：R733.1[医药卫生—肿瘤]