Division of Hematology and Oncology, Memorial Hospital of Rhode Island, Pawtucket, RI 02860, USA.
Cancer. 2013 Feb 1;119(3):629-38. doi: 10.1002/cncr.27773. Epub 2012 Aug 14.
BACKGROUND.: Prognostic factors and outcomes in patients with marginal zone lymphoma (MZL) have been studied in small cohort studies, which may not reflect the population at large. METHODS.: Clinical characteristics and survival outcomes of adult patients with MZL who were diagnosed between 1995 and 2009 were evaluated using the Surveillance, Epidemiology, and End Results (SEER) database. The authors generated clinical prognostic models for subtypes of MZL and compared survival during the periods of 1995 through 2000, 2001 through 2004, and 2005 through 2009. RESULTS.: The prognosis was significantly better for patients with mucosa-associated lymphoid tissue (MALT) lymphoma (5-year relative survival rate of 88.7%; P < .0001) compared with those with the splenic MZL (SMLZ)or nodal MZL (NMZL) subtypes (5-year relative survival rates of 79.7% and 76.5%, respectively). There was evidence of improved outcomes in patients with NMZL and MALT lymphomas between 1995 and 2009 (P < .0001), with no difference noted in patients with SMZL (P = .56). Advancing age and the presence of B symptoms had prognostic significance in all MZL subtypes. Male sex and stage of disease were significant only for the NMZL and MALT categories. Survival in patients with MALT lymphomas varied depending on the site of origin, with a worse prognosis noted in those with gastrointestinal and pulmonary locations of origin (5-year incidence rate of lymphoma-related death, 9.5%-14.3%) compared with ocular, cutaneous, and endocrine sites (4.5%-7.8%; P < .0001). CONCLUSIONS.: The survival for patients with SMZL is similar to that for those with NMZL, and unlike the NMZL and MALT subtypes, it has not improved over the past decade. The prognosis of patients with MALT lymphoma varies according to the anatomical site of origin.
边缘区淋巴瘤（MZL）患者的预后因素和结局已在小队列研究中进行了研究，但这些研究可能无法反映总体人群的情况。方法：使用监测、流行病学和最终结果（SEER）数据库评估了 1995 年至 2009 年间诊断的成人 MZL 患者的临床特征和生存结局。作者为 MZL 各亚型生成了临床预后模型，并比较了 1995 年至 2000 年、2001 年至 2004 年和 2005 年至 2009 年期间的生存情况。结果：与脾边缘区淋巴瘤（SMZL）或结外边缘区淋巴瘤（NMZL）亚型相比，黏膜相关淋巴组织（MALT）淋巴瘤患者的预后明显更好（5 年相对生存率分别为 88.7%和 79.7%，P<.0001）。1995 年至 2009 年间，NMZL 和 MALT 淋巴瘤患者的结局有所改善（P<.0001），而 SMZL 患者的结局无差异（P=.56）。在所有 MZL 亚型中，年龄增长和 B 症状存在均具有预后意义。男性和疾病分期仅对 NMZL 和 MALT 类别具有重要意义。MALT 淋巴瘤患者的生存因起源部位而异，胃肠道和肺部起源的患者预后较差（淋巴瘤相关死亡的 5 年发生率为 9.5%-14.3%），而眼部、皮肤和内分泌部位的患者预后较好（4.5%-7.8%；P<.0001）。结论：SMZL 患者的生存率与 NMZL 患者相似，且与 NMZL 和 MALT 亚型不同，过去十年中并未改善。MALT 淋巴瘤患者的预后因解剖起源部位而异。
