头颈部黏膜相关淋巴组织淋巴瘤的临床特征

Clinical features of mucosa-associated lymphoid tissue lymphoma in head and neck

目的:总结头颈部黏膜相关淋巴组织(MALT)淋巴瘤的临床特征、诊断及治疗方法。方法:回顾性分析收治的22例头颈部MALT淋巴瘤患者的临床资料。结果:22例患者中发病部位分别为唾液腺13例,喉及气管4例,鼻咽部3例,甲状腺2例。临床上均表现为局部占位病变或压迫症状。化疗或放化疗12例,手术加化疗5例,手术加放疗3例,单纯手术切除及单纯放疗各1例。15例在初始治疗后病变完全缓解,6例部分缓解,1例疾病稳定。平均随访时间92个月(8～211个月)。随访期间共18例患者生存,4例死亡,3年无进展生存率及总生存率均为95.2%,5年无进展生存率及总生存率分别为79.4%及89.6%。结论:头颈部MALT淋巴瘤预后较好,无特异性临床表现,治疗上以化疗为主,病变局限者可选择局部治疗。

Objective: To summarize the clinical features, diagnosis and treatment of mucosa-associated lymphoid tissue(MALT) lymphoma in head and neck. Method: The clinical data of 22 hospitalizedpatients with MALT lymphoma in head and neck during the recent 18 years were analyzed retrospectively. Result: Among the 22 cases, 13 patients showed salivary gland lesions, 4 showed larynx and trachea lesions, 3 showed nasopharynx lesions and 2 showed thyroid gland lesions. The clinical manifestation was occupying or compression. Among them, 12 patients received chemotherapy or chemoradiotherapy, 5 received surgery plus chemotherapy, 3 received surgery plus radiotherapy, 1 received surgery alone and 1 received radiotherapy alone;complete response(CR) occurred in 15 patients, partial response(PR) occurred in 6 patients, and 1 was stable disease(SD). The mean follow-up time was 92(8-211) months. During the follow-up period, 18 patients survived, 4 died, the three-year progression free survival(PFS) and overall survival(OS) were both 95.2%, and the five-year PFS and OS were 79.4% and 89.6% respectively. Conclusion: The prognosis of MALT lymphoma in head and neck was good. MALT lymphoma has no specific clinical manifestations. Chemotherapy was the main treatment. Local treatment can be conducted for patients with localized lesions.