Lee Chang Min, Lee Dong Ho, Ahn Byung Kyu, Hwang Jae Jin, Yoon Hyuk, Park Young Soo, Shin Cheol Min, Kim Nayoung
Division of Gastroenterology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
Clin Endosc. 2017 Jan;50(1):51-57. doi: 10.5946/ce.2016.015. Epub 2016 Mar 24.
BACKGROUND/AIMS: In gastric mucosa-associated lymphoid tissue (MALT) lymphoma, the clinical significance of various endoscopic findings has not yet been determined. This study aimed to compare the time to complete remission (CR) and relapse-free survival (RFS) in gastric MALT lymphoma based on endoscopic findings.
In this single-center retrospective cohort study, the medical records of 122 consecutive adult patients with gastric MALT lymphoma were collected over a period of 12 years. CR was defined by the absence of macroscopic or microscopic features of lymphoma on two subsequent follow-ups. Relapse was clinically defined by a positive endoscopic biopsy after CR.
The median time to CR did not differ significantly between treatment methods. However, it was significantly longer in the group with polypoid endoscopic appearance than in the groups with diffuse infiltration or ulceration (7.83, 3.43, and 3.10 months, respectively; =0.003). Six patients relapsed after CR. Kaplan-Meier analysis showed that RFS differed significantly between groups based on Ann Arbor staging, treatment methods, and initial endoscopic findings.
In gastric MALT lymphoma, the endoscopically defined polypoid type was characterized by a longer duration to CR, with a higher likelihood of recurrence, compared to the endoscopically defined diffuse infiltration or ulceration types.
背景/目的:在胃黏膜相关淋巴组织(MALT)淋巴瘤中,各种内镜检查结果的临床意义尚未确定。本研究旨在根据内镜检查结果比较胃MALT淋巴瘤的完全缓解(CR)时间和无复发生存期(RFS)。
在这项单中心回顾性队列研究中,收集了连续12年的122例成年胃MALT淋巴瘤患者的病历。CR定义为在随后的两次随访中无淋巴瘤的宏观或微观特征。复发在临床上定义为CR后内镜活检阳性。
治疗方法之间达到CR的中位时间无显著差异。然而,内镜下呈息肉样表现的组达到CR的时间明显长于弥漫浸润或溃疡组(分别为7.83、3.43和3.10个月;P = 0.003)。6例患者在CR后复发。Kaplan-Meier分析显示,基于Ann Arbor分期、治疗方法和初始内镜检查结果,各组之间的RFS有显著差异。
在胃MALT淋巴瘤中,与内镜下定义的弥漫浸润或溃疡型相比,内镜下定义的息肉样型的特点是达到CR的持续时间更长,复发可能性更高。