90例原发胃肠道黏膜相关淋巴组织结外边缘区B细胞淋巴瘤患者临床特征与预后分析

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.