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黏膜相关淋巴组织边缘区淋巴瘤(MALT 淋巴瘤)的临床病理特征和治疗。

Clinicopathologic characteristics and treatment of marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma).

机构信息

Programme Director for Extranodal Lymphomas, Department of Internal Medicine I, Division of Oncology, Medical University Vienna, Vienna, Austria.

Resident-in-Training, Department of Internal Medicine I, Division of Oncology, Medical University Vienna, Vienna, Austria.

出版信息

CA Cancer J Clin. 2016 Mar-Apr;66(2):153-71. doi: 10.3322/caac.21330. Epub 2015 Nov 24.

Abstract

Extranodal marginal zone lymphoma of the mucosa-associated lymphoid tissue (MALT lymphoma) accounts for 7% to 8% of newly diagnosed lymphomas. Because of its association with infectious causes, such as Helicobacter pylori (HP) or Chlamydophila psittaci (CP), and autoimmune diseases, it has become the paradigm of an antigen-driven malignancy. MALT lymphoma usually displays an indolent course, and watch-and-wait strategies are justified initially in a certain percentage of patients. In patients with gastric MALT lymphoma or ocular adnexal MALT lymphoma, antibiotic therapy against HP or CP, respectively, is the first-line management of choice, resulting in lymphoma response rates from 75% to 80% after HP eradication and from 33% to 65% after antibiotic therapy for CP. In patients who have localized disease that is refractory to antibiotics, radiation is widely applied in various centers with excellent local control, whereas systemic therapies are increasingly being applied, at least in Europe, because of the potentially systemic nature of the disease. Therefore, the objective of this review is to briefly summarize the clinicopathologic characteristics of this distinct type of lymphoma along with current data on management strategies.

摘要

黏膜相关淋巴组织(MALT)结外边缘区淋巴瘤占新诊断淋巴瘤的 7%至 8%。由于其与感染性病因(如幽门螺杆菌(HP)或鹦鹉热衣原体(CP))和自身免疫性疾病有关,它已成为抗原驱动恶性肿瘤的范例。MALT 淋巴瘤通常表现为惰性病程,在一定比例的患者中最初可以采用观察等待策略。在胃 MALT 淋巴瘤或眼附属器 MALT 淋巴瘤患者中,针对 HP 或 CP 的抗生素治疗分别是首选的一线治疗方法,在 HP 根除后淋巴瘤缓解率为 75%至 80%,在 CP 抗生素治疗后缓解率为 33%至 65%。对于对抗生素治疗有局部疾病且无反应的患者,放射治疗在各个中心广泛应用,具有极好的局部控制效果,而系统治疗,至少在欧洲,越来越多地被应用,因为这种疾病具有潜在的全身性。因此,本综述的目的是简要总结这种独特类型淋巴瘤的临床病理特征以及当前的管理策略数据。

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