Zhou Meng-Xin, Chen Ye-Ye, Zhang Jia-Qi, Bai Wen-Liang, Huang Cheng, Guo Chao, Liu Hong-Sheng, Li Shan-Qing
Department of Thoracic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
J Thorac Dis. 2022 Aug;14(8):2894-2907. doi: 10.21037/jtd-22-81.
Mucosa-associated lymphoid tissue (MALT) lymphoma of the thymus is a rare disease. The present meta-analysis aims at accumulating current evidence to explore the clinical characteristics, treatments, and prognoses of thymic MALT lymphoma.
We searched seven databases for studies published between the start date of database establishment and September 15, 2021. We included studies of patients with histological diagnoses and excluded those without data specifically on thymic MALT lymphoma. The quality was analyzed using an assessment tool. All data were tabulated. Pooled proportion was obtained using random-effects model. Statistical analysis was performed on R statistic software.
Overall, 52 case reports and 13 case series were eligible. The quality of case reports was inferior to that of case series in terms of selection (P<0.001). Based on the analysis of patients in the case reports, age, gender, concurrent diseases, and tumor size did not differ between limited-stage and advanced-stage cases. Surgery is the mainstay to treat thymic MALT lymphoma. The surgical approach and extent did not influence the occurrence of events. Patients at Ann Arbor stage I were prone to not receiving postoperative therapy (P=0.011), though it may not reduce the occurrence of events (P=0.637). The five-year overall survival (OS) rate and five-year progression-free survival (PFS) rate were 97.2% and 88.4%, respectively. Patients with advanced-stage disease were more likely to suffer events (P=0.009).
Thymic MALT lymphoma is an extremely rare disease with a favorable prognosis. Currently available evidence is insufficient to draw solid judgments about treatment and prognosis. However, patients may benefit if thymectomy is chosen as the primary treatment. In some patients, lymph node sampling or dissection should be considered. In addition, if the patient is at an advanced-stage, postoperative therapy should be considered.
胸腺黏膜相关淋巴组织（MALT）淋巴瘤是一种罕见疾病。本荟萃分析旨在积累现有证据，以探索胸腺MALT淋巴瘤的临床特征、治疗方法和预后情况。
我们检索了七个数据库，查找自建库起始日期至2021年9月15日期间发表的研究。我们纳入了组织学诊断患者的研究，排除了那些没有关于胸腺MALT淋巴瘤具体数据的研究。使用评估工具分析质量。所有数据制成表格。采用随机效应模型获得合并比例。在R统计软件上进行统计分析。
总体而言，52篇病例报告和13个病例系列符合条件。病例报告在选择方面的质量低于病例系列（P<0.001）。基于对病例报告中患者的分析，局限期和晚期病例在年龄、性别、合并疾病和肿瘤大小方面没有差异。手术是治疗胸腺MALT淋巴瘤的主要方法。手术方式和范围不影响事件的发生。Ann Arbor I期患者术后更倾向于不接受治疗（P=0.011），尽管这可能不会降低事件的发生率（P=0.637）。五年总生存率（OS）和五年无进展生存率（PFS）分别为97.2%和88.4%。晚期疾病患者更易发生事件（P=0.009）。
胸腺MALT淋巴瘤是一种极其罕见的疾病，预后良好。目前可得的证据不足以对治疗和预后做出确凿判断。然而，如果选择胸腺切除术作为主要治疗方法，患者可能会受益。在一些患者中，应考虑进行淋巴结采样或清扫。此外，如果患者处于晚期，应考虑术后治疗。
