胃黏膜相关淋巴组织淋巴瘤患者68例临床预后分析

Analysis of clinical prognosis of 68 patients with gastric mucosa-associated lymphoid tissue lymphoma

目的探讨胃黏膜相关淋巴组织淋巴瘤的临床特征及预后。方法收集2000—2019年北京大学肿瘤医院诊治的胃黏膜相关淋巴组织淋巴瘤患者资料,对其临床特征、治疗方案及效果、预后转归进行回顾性分析。结果68例患者的中位年龄为56岁,男女比例为0.6∶1.0。早期患者约占76%(52/68)。最常用的治疗方案为根除幽门螺杆菌治疗,其次为放疗和化疗。总有效率为94%(60/64),其中完全缓解率为72%(46/64)。中位随访44个月,5年无进展生存(PFS)率为73%,总生存(OS)率为83%。预后因素分析显示,白蛋白水平(P=0.011)和国际预后指数(IPI)(P=0.017)是PFS的独立预后指标,白蛋白正常和降低患者的5年PFS率分别为77%和50%,IPI评分<2分和IPI≥2分患者的5年PFS率分别为80%和48%;乳酸脱氢酶(LDH)水平(P=0.016)和白蛋白水平(P=0.025)是OS的独立预后指标,LDH正常和升高患者的5年OS率分别为87%和67%。白蛋白正常和降低患者的5年OS率分别为92%和73%。结论胃黏膜相关淋巴组织淋巴瘤对治疗敏感,预后佳,患者白蛋白及LDH水平是独立预后指标。

Objective To explore the clinical features and prognosis of gastric mucosa-associated lymphoid tissue lymphoma.Methods The data of patients with gastric mucosa-associated lymphoid tissue lymphoma diagnosed and treated at Peking University Cancer Hospital from 2000 to 2019 were collected,and their clinical characteristics,treatment options and effects,and prognosis were retrospectively analyzed.Results The median age of 68 patients was 56 years old,and the ratio of men to women was 0.6∶1.0.Early patients accounted for about 76%(52/68).The most commonly used treatment is Helicobacter pylori eradication,followed by radiotherapy and chemotherapy.The total effective rate is 94%,of which the complete remission rate is 72%.With a median follow-up of 44 months,the 5-year progression-free survival(PFS)rate was 73%,and the overall survival(OS)rate was 83%.Prognostic factor analysis showed that albumin level(P=0.011)and international prognostic index(IPI)(P=0.017)are independent prognostic indicators of PFS,The 5-year PFS rate of patients with normal and reduced albumin was 77%and 50%,respectively,and the 5-year PFS rate of patients with IPI score<2 points and IPI≥2 points was 80%and 48%,respectively.Lactate dehydrogenase(LDH)(P=0.016)and albumin level(P=0.025)are independent prognostic indicators of OS,and the 5-year OS rates of patients with normal and elevated LDH were 87%and 67%,respectively.The 5-year OS rates of patients with normal albumin and reduced were 92%and 73%,respectively.Conclusions Gastric mucosa-associated lymphoid tissue lymphoma is sensitive to treatment and has a good prognosis.The patient′s albumin and lactate dehydrogenase levels are independent prognostic indicators.