Department of Internal Medicine I, Division of Oncology, A-1090 Vienna, Austria.
Anticancer Res. 2010 Feb;30(2):635-9.
The prognostic values of the International Prognostic Index (IPI) and the Follicular Lymphoma International Prognostic Index (FLIPI) have widely been demonstrated in diffuse large B-cell lymphoma and follicular lymphoma. No attempts to assess their applicability in MALT lymphoma have been made so far.
A total of 143 patients with MALT-lymphoma were analysed. Parameters of both IPI and FLIPI were retrospectively assessed and correlated with relapse and time to relapse as markers of clinical course.
According to IPI, 96 patients (67%) were classified as low, 22 (15%) low-intermediate, 17 (12%) high-intermediate and 8 (6%) as high risk. FLIPI identified 99 patients (70%) at low risk, 35 (24%) at intermediate and 9 (6%) at high risk. After a median follow-up time of 39.5 months, 123 patients were alive and 46 patients had relapsed (median time to relapse 27 months). IPI significantly correlated with time to relapse, with the typical differentiation into low, low-intermediate and high risk groups. FLIPI divided patients into three groups, but the low and intermediate risk groups showed a similar clinical course. In terms of additional progonostic factors, univariate analysis suggested autoimmune disease and multifocal disease as correlated with relapse. Multiple regression analysis, however, identified only extragastric disease as predictive of relapse (p=0.001).
Our data demonstrate that both IPI and FLIPI are able to discriminate prognostic subgroups in patients with MALT-lymphoma. However, the low and intermediate group of the FLIPI did not appear to prognostically differ.
国际预后指数（IPI）和滤泡性淋巴瘤国际预后指数（FLIPI）的预后价值已在弥漫性大 B 细胞淋巴瘤和滤泡性淋巴瘤中得到广泛证实。目前尚未尝试评估它们在黏膜相关淋巴组织（MALT）淋巴瘤中的适用性。
共分析了 143 例 MALT 淋巴瘤患者。回顾性评估了 IPI 和 FLIPI 的各项参数，并将其与复发和复发时间相关联，作为临床病程的标志物。
根据 IPI，96 例（67%）患者被分类为低危，22 例（15%）为低中危，17 例（12%）为高中危，8 例（6%）为高危。FLIPI 则将 99 例（70%）患者归类为低危，35 例（24%）为中危，9 例（6%）为高危。在中位数为 39.5 个月的随访期间，123 例患者存活，46 例患者复发（复发中位时间为 27 个月）。IPI 与复发时间显著相关，典型地分为低危、低中危和高危组。FLIPI 将患者分为三组，但低危和中危组的临床病程相似。就额外的预后因素而言，单因素分析提示自身免疫性疾病和多发病灶与复发相关。然而，多因素回归分析仅发现胃外疾病是复发的预测因素（p=0.001）。
我们的数据表明，IPI 和 FLIPI 均能够区分 MALT 淋巴瘤患者的预后亚组。然而，FLIPI 的低危和中危组在预后上似乎没有差异。
