He Yujie, Gao Chengwen
Medical Research Center, The Affiliated Hospital of Qingdao University, Qingdao, Shangdong, 266000, China.
West Coast Second Hospital of Qingdao University Medical Group, Qingdao, Shangdong, 266000, China.
Sci Rep. 2025 Jul 1;15(1):20407. doi: 10.1038/s41598-025-07413-8.
Extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT) is the third most prevalent subtype of mature B-cell lymphomas. While MALT lymphoma typically has a favorable prognosis, the outlook can worsen dramatically if histological transformation (HT) occurs, usually into a more aggressive form like diffuse large B-cell lymphoma (DLBCL). Large-scale study with long-term follow-up specifically focused on the transformation of MALT lymphoma is limited. This study utilized the SEER database to analyze 20,944 patients diagnosed with MALT lymphoma from 2000 to 2020. We also included a cohort of de novo DLBCL patients for comparison. Our findings showed that HT occurred in 1.59% of MALT lymphoma cases, with 5- and 10-year cumulative incidences of 1.2% and 2.2%, respectively. Patients presenting with B symptoms, age ≥ 60, and advanced-stage disease were at a significantly higher risk for HT. The median time to transformation was 3.67 years. Both univariate and multivariate analyses demonstrated that age ≥ 60 was a significant adverse factor for lymphoma-specific survival (LSS) and overall survival (OS) following HT. This population-based study contributes to the characterization of transformation risk and outcomes in MALT lymphoma and may help inform clinical surveillance strategies.
黏膜相关淋巴组织（MALT）结外边缘区B细胞淋巴瘤是成熟B细胞淋巴瘤中第三常见的亚型。虽然MALT淋巴瘤通常预后良好，但如果发生组织学转化（HT），通常转化为更具侵袭性的形式，如弥漫性大B细胞淋巴瘤（DLBCL），预后可能会显著恶化。专门针对MALT淋巴瘤转化进行长期随访的大规模研究有限。本研究利用监测、流行病学和最终结果（SEER）数据库分析了2000年至2020年期间诊断为MALT淋巴瘤的20944例患者。我们还纳入了一组初发性DLBCL患者进行比较。我们的研究结果显示，1.59%的MALT淋巴瘤病例发生了HT，5年和10年累积发生率分别为1.2%和2.2%。出现B症状、年龄≥60岁和疾病晚期的患者发生HT的风险显著更高。转化的中位时间为3.67年。单因素和多因素分析均表明，年龄≥60岁是HT后淋巴瘤特异性生存（LSS）和总生存（OS）的显著不利因素。这项基于人群的研究有助于明确MALT淋巴瘤的转化风险和转归特征，并可能有助于指导临床监测策略。
