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甲状腺黏膜相关淋巴组织淋巴瘤:文献系统综述

Mucosa-Associated Lymphoid Tissue Lymphoma of the Thyroid Gland: A Systematic Review of the Literature.

作者信息

Karvounis Evangelos, Kappas Ioannis, Angelousi Anna, Makris Georgios-Marios, Kassi Eva

机构信息

Department of Endocrine Surgery Center of Excellence, Euroclinic Hospital, Athens, Greece.

First Department of Internal Medicine, Laiko Hospital, National and Kapodistrian University of Athens, Athens, Greece.

出版信息

Eur Thyroid J. 2020 Jan;9(1):11-18. doi: 10.1159/000502204. Epub 2019 Nov 18.

Abstract

OBJECTIVE

Extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT) type of the thyroid gland is a rare indolent malignant disease encountered in approximately 0.5% of patients with Hashimoto thyroiditis (HT). The purpose of the present systematic review was to accumulate the current evidence in the field.

STUDY DESIGN

We searched the Medline, Scopus, EMBASE, ClinicalTrials.gov, and Cochrane Central Register of Controlled Trials databases from inception to May 2018. Statistical analysis was performed with SPSS version 22.0.

RESULTS

Fourteen case series and 20 case reports were finally included in the present systematic review. Analysis of the patient data included in the published case reports suggested that the age at diagnosis of MALT lymphoma does no differ among males and females (64 [52.5-73] vs. 67 [60.5-72] years, = 0.442). HT was detected in 60% of patients, whereas coexisting carcinoma was evident in 17% of cases. The incidence of HT and thyroid cancer was comparable among males and females ( = 0.474 and > 0.999, respectively). Among all patients included in the present systematic review there were two disease relapses and two deaths attributed to the disease.

CONCLUSION

MALT lymphoma of the thyroid gland is a rare malignancy with an indolent course. The scarce data available in the literature preclude safe conclusions concerning the mode of treatment and follow-up of these patients. However, the combination of minimally invasive surgery and adjuvant therapy seems feasible. Moreover, an extended follow-up period is recommended.

摘要

目的

甲状腺黏膜相关淋巴组织(MALT)型结外边缘区B细胞淋巴瘤是一种罕见的惰性恶性疾病,约0.5%的桥本甲状腺炎(HT)患者会出现该疾病。本系统评价的目的是积累该领域的现有证据。

研究设计

我们检索了从创建至2018年5月的Medline、Scopus、EMBASE、ClinicalTrials.gov和Cochrane对照试验中央注册库数据库。使用SPSS 22.0版进行统计分析。

结果

本系统评价最终纳入了14个病例系列和20篇病例报告。对已发表病例报告中纳入的患者数据进行分析表明,MALT淋巴瘤的诊断年龄在男性和女性之间无差异(64[52.5 - 73]岁对67[60.5 - 72]岁,P = 0.442)。60%的患者检测出HT,而17%的病例存在共存癌。HT和甲状腺癌的发病率在男性和女性中相当(分别为P = 0.474和P>0.999)。在本系统评价纳入的所有患者中,有2例疾病复发,2例死亡归因于该疾病。

结论

甲状腺MALT淋巴瘤是一种罕见的恶性肿瘤,病程呈惰性。文献中可用数据稀少,无法就这些患者的治疗方式和随访得出可靠结论。然而,微创手术和辅助治疗相结合似乎可行。此外,建议延长随访期。

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