Liu Rui, Wang Jinjin, Wang Nan, Li Jing, Ge Xin, Zhang Jingxue, Ma Jianmin
Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
Front Oncol. 2021 Mar 8;11:622847. doi: 10.3389/fonc.2021.622847. eCollection 2021.
The clinical characteristics and prognoses of immunoglobulin G4-positive (IgG4+) and IgG4-negative (IgG4-) lacrimal lymphomas were comparatively analyzed to screen for clinical indicators with differential diagnostic significance. This was a retrospective and single-center clinical study. From June 2011 to June 2018, clinical data of 39 patients with lacrimal lymphoma, diagnosed by histopathology were collected from the Department of Ophthalmology, Beijing Tongren Hospital, Capital Medical University. According to inclusion and exclusion criteria, 30 (76.9%) were in the IgG4- group and 9 (23.1%) were in the IgG4+ group. In the IgG4+ group, the sex ratio of male to female was 2:1 and the mean age was 56.67 ± 13.29 years old. In the IgG4- group, the sex ratio of male to female was 3.29:1 and the mean age was 61.47 ± 12.87 years old. Statistical analysis of the clinical indicators showed significant differences between the two groups in affected eye, preoperative history of glucocorticoids, ocular nerve thickening, the expression of serum IgG4 and prognosis ( < 0.05). There was no significant statistical difference in laboratory indicators between the two groups, including C3, C4, RF, ASO, CRP, IgA, IgM, IgG, IgG1, IgG2, and IgG3 ( > 0.05). The event-free cumulative percentages at 3 and 5 years for the 39 lacrimal lymphomas were 81.1 and 62.4%, respectively, with recurrence and death as end events. In 34 lacrimal gland MALT lymphoma cases, the event-free cumulative percentages at 3 and 5 years were 84.4 and 69.1%, respectively. In the IgG4+ and IgG4- groups, the event-free cumulative percentages at 3 years were 75.0 and 87.7%, respectively. The event-free cumulative percentage at 5 years was 62.6% in the IgG4-group and insignificant in the IgG4+ group. There was no statistical difference in event-free cumulative percentage between the two groups ( = 0.983). The pathogenesis and disease characteristics of IgG4-positive lacrimal lymphoma may differ from IgG4-negative lacrimal lymphoma, but the positive expression of IgG4 may not have significant influence on the recurrence of lacrimal lymphoma.
对免疫球蛋白G4阳性（IgG4+）和IgG4阴性（IgG4-）泪腺淋巴瘤的临床特征及预后进行比较分析，以筛选具有鉴别诊断意义的临床指标。这是一项回顾性单中心临床研究。2011年6月至2018年6月，从首都医科大学附属北京同仁医院眼科收集39例经组织病理学确诊的泪腺淋巴瘤患者的临床资料。根据纳入和排除标准，IgG4-组30例（76.9%），IgG4+组9例（23.1%）。IgG4+组男女比例为2:1，平均年龄为56.67±13.29岁。IgG4-组男女比例为3.29:1，平均年龄为61.47±12.87岁。对临床指标进行统计学分析，结果显示两组在患眼、糖皮质激素术前使用史、视神经增粗、血清IgG4表达及预后方面存在显著差异（P<0.05）。两组的实验室指标，包括C3、C4、RF、ASO、CRP、IgA、IgM、IgG、IgG1、IgG2和IgG3，差异无统计学意义（P>0.05）。39例泪腺淋巴瘤患者3年和5年的无事件累积百分比分别为81.1%和62.4%，以复发和死亡作为终末事件。34例泪腺黏膜相关淋巴组织淋巴瘤患者3年和5年的无事件累积百分比分别为84.4%和69.1%。在IgG4+组和IgG4-组中，3年的无事件累积百分比分别为75.0%和87.7%。IgG4-组5年的无事件累积百分比为62.6%，IgG4+组无显著差异。两组间无事件累积百分比差异无统计学意义（P=0.983）。IgG4阳性泪腺淋巴瘤的发病机制和疾病特征可能与IgG4阴性泪腺淋巴瘤不同，但IgG4的阳性表达可能对泪腺淋巴瘤的复发无显著影响。
