早期低级别胃黏膜相关淋巴组织（MALT）肿瘤很少转化为弥漫性大 B 细胞淋巴瘤，也很少向胃外和区域淋巴结进展。
Early low-grade gastric MALToma rarely transforms into diffuse large cell lymphoma or progresses beyond the stomach and regional lymph nodes.
机构信息
Department of Pathology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
出版信息
J Formos Med Assoc. 2010 Jun;109(6):463-71. doi: 10.1016/S0929-6646(10)60078-2.
BACKGROUND/PURPOSE: Gastric mucosa-associated lymphoid tissue lymphoma (MALToma) usually presents at an early stage involving only the stomach and/or regional lymph nodes. Although a sequential transformation from low-grade gastric MALToma (GM) to high-grade GM to secondary diffuse large B-cell lymphoma (DLBCL) is commonly assumed, documented cases of transformation are rare. We aim to determine the frequency of transformation.
METHODS
We identified 55 early low-grade GMs, 18 early high-grade GMs, and 13 advanced GMs at the National Taiwan University Hospital from 1995 to 2005. The median follow-up time was 59 months.
RESULTS
We found that only one early low-grade GM and two early high-grade GMs transformed into secondary DLBCLs and progressed outside the stomach and regional lymph nodes. Significantly, we identified 13 low-grade GMs that were refractory to Helicobacter eradication therapy or relapsed after initial response. All 13 cases had been followed-up for at least 3 years without development of secondary DLBCLs. The frequency of transformation for early low-grade GM was less than 2% (1/55). Although two lymphoma-unrelated mortalities were identified, none of the 55 patients with early-low grade GMs died of the disease.
CONCLUSION
Compared with chronic lymphocytic leukemia, which has a 16% transformation rate and a median transformation time of 24 months, we conclude that early low-grade GM rarely transforms into secondary DLBCL or progresses beyond the stomach. Without transformation or progression, patients with early low-grade GM rarely die of the disease and should be treated conservatively.
背景/目的：胃黏膜相关淋巴组织淋巴瘤（MALToma）通常在早期出现，仅累及胃和/或局部淋巴结。尽管通常假定从低级别胃 MALToma（GM）到高级别 GM 再到继发性弥漫性大 B 细胞淋巴瘤（DLBCL）的连续转化，但有文献记载的转化病例很少。我们旨在确定转化的频率。
方法
我们从 1995 年至 2005 年在国立台湾大学医院确定了 55 例早期低级别 GM、18 例早期高级别 GM 和 13 例晚期 GM。中位随访时间为 59 个月。
结果
我们发现只有 1 例早期低级别 GM 和 2 例早期高级别 GM 转化为继发性 DLBCL，并在胃和局部淋巴结外进展。值得注意的是，我们确定了 13 例对幽门螺杆菌根除治疗无反应或初始反应后复发的低级别 GM。这 13 例均至少随访 3 年，未发生继发性 DLBCL。早期低级别 GM 的转化频率小于 2%（1/55）。虽然发现了 2 例与淋巴瘤无关的死亡，但55 例早期低级别 GM 患者均未因疾病死亡。
结论
与转化率为 16%且中位转化时间为 24 个月的慢性淋巴细胞白血病相比，我们得出的结论是早期低级别 GM 很少转化为继发性 DLBCL 或超出胃的范围进展。没有转化或进展，早期低级别 GM 患者很少因疾病死亡，应保守治疗。
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