Arcaini L, Burcheri S, Rossi A, Paulli M, Bruno R, Passamonti F, Brusamolino E, Molteni A, Pulsoni A, Cox M C, Orsucci L, Fabbri A, Frezzato M, Voso M T, Zaja F, Montanari F, Merli M, Pascutto C, Morra E, Cortelazzo S, Lazzarino M
Division of Hematology, IRCCS Policlinico San Matteo, University of Pavia, Italy.
Ann Oncol. 2007 Feb;18(2):346-50. doi: 10.1093/annonc/mdl388. Epub 2006 Oct 27.
Hepatitis C virus (HCV) infection is frequently associated with B-cell non-Hodgkin's lymphomas. We investigated the prevalence of HCV infection in nongastric marginal zone lymphomas of mucosa-associated lymphoid tissue (MALT) in order to define the relationship between the viral infection and the presenting features, treatment, and outcome.
We retrospectively studied 172 patients with a histological diagnosis of marginal zone B-cell lymphoma of MALT, except for stomach, and with available HCV serology, among a series of 208 patients.
HCV infection was documented in 60 patients (35%). Most HCV-positive patients (97%) showed a single MALT organ involvement. HCV-positive patients showed a more frequent involvement of skin (35%), salivary glands (25%), and orbit (15%). The majority of stage IV HCV-positive patients (71%) had a single MALT site with bone marrow involvement. The overall response rate was similar in HCV-positive (93%) and HCV-negative patients (87%). Overall survival (OS) and event-free survival (EFS) did not differ according to HCV infection. In multivariate analysis, advanced disease (stage III-IV) was associated with a poorer OS (P = 0.0001), irrespective of HCV serostatus.
This study shows that nongastric marginal zone lymphomas are characterized by a high prevalence of HCV infection. Patients with involvement of a single MALT site have the highest prevalence of HCV. HCV-positive nongastric lymphomas of MALT show an indolent course similar to HCV-negative patients and seem an ideal target for exploiting the antilymphoma activity of antiviral treatments.
丙型肝炎病毒(HCV)感染常与B细胞非霍奇金淋巴瘤相关。我们调查了黏膜相关淋巴组织(MALT)非胃边缘区淋巴瘤中HCV感染的患病率,以明确病毒感染与临床表现、治疗及预后之间的关系。
我们对208例患者中的172例经组织学诊断为非胃MALT边缘区B细胞淋巴瘤且有可用HCV血清学检查结果的患者进行了回顾性研究。
60例患者(35%)有HCV感染记录。大多数HCV阳性患者(97%)表现为单个MALT器官受累。HCV阳性患者皮肤(35%)、唾液腺(25%)和眼眶(15%)受累更为常见。大多数IV期HCV阳性患者(71%)有单个MALT部位伴骨髓受累。HCV阳性患者(93%)和HCV阴性患者(87%)的总体缓解率相似。根据HCV感染情况,总生存期(OS)和无事件生存期(EFS)并无差异。多因素分析显示,无论HCV血清学状态如何,晚期疾病(III-IV期)与较差的OS相关(P = 0.0001)。
本研究表明,非胃边缘区淋巴瘤的特点是HCV感染患病率高。单个MALT部位受累的患者HCV患病率最高。HCV阳性的非胃MALT淋巴瘤病程与HCV阴性患者相似,呈惰性,似乎是利用抗病毒治疗的抗淋巴瘤活性的理想靶点。