涎腺黏膜相关淋巴组织淋巴瘤的研究进展

Research progress of mucosa-associated lymphoid tissue lymphoma arising in the salivary gland

涎腺黏膜相关淋巴组织淋巴瘤的发病与免疫和慢性感染密切相关,如舍格伦综合征和慢性自身免疫性甲状腺炎以及丙型肝炎病毒、E-B病毒、人类疱疹病毒、人类嗜T淋巴细胞病毒和人类免疫缺陷病毒感染。该病通常无染色体易位,但与某些化学增活素和良性淋巴上皮病变有关,染色体增殖方式较为保守且增加多于丢失,其靶基因表现为积极地调整细胞的寿命和增殖。该病的临床表现为无痛,病程迁延,需要长期地观察和反复活检方能确诊,放射和化学治疗均敏感,多病灶者常需多种手段的联合治疗。该病预后较好,复发率较其他黏膜相关淋巴组织淋巴瘤高,还有可能伴发涎腺肿胀症、肌上皮涎腺炎和二次癌症以及远处播散,甚至累及骨髓,长时间、仔细地观察随访对其预后十分重要。

Salivary gland mucesa-associated lymphoid tissue lymphoma is associated with autoimmune diseases and chronic infections, such as Sjogren syndrome, chronic autoimmune disease, hepatitis C virus, Epstein-Barr virus, herpesvirus, human T-cell lymphoma virus, human immunodeficiency virus. Chromosome translocation has seldom been observed in this disease, but it relates to definite chemokines, showing a conserved pattern of chromosomal gains, which appear to target genes positively modulating cell survival and proliferation, and has a background of benign lymphoepithelial lesion. It shows a chronic, painless clinical course. A long-term follow-up and repeating biopsy are needed to diagnosis. Radiotherapy and ehemo are both responsive, and disseminated disease at multiple sites need therapeutic alliance. It has a good prognosis, although with a higher relapse rate than oher type of mucosa-associated lymphoid tissue lymphoma, and salivary gland swelling, myoepithelial sialadenitis, second-cancer and metastasis may also take place, even involves bone marrow. A long-term and attentive follow-up is important to the prognosis.