在一项基于人群的登记研究中，胃淋巴瘤与淋巴结淋巴瘤相比，在分期分布和播散模式上存在差异，但在患者生存率方面并无差异。

Gastric lymphomas compared with lymph node lymphomas in a population-based registry differ in stage distribution and dissemination patterns but not in patient survival.

作者信息

Krol A D, Hermans J, Kramer M H, Kluin P M, Kluin-Nelemans H C, Blok P, Heering K J, Noordijk E M, van Krieken J H

机构信息

Department of Clinical Oncology, Leiden University Hospital, The Netherlands.

出版信息

Cancer. 1997 Jan 15;79(2):390-7. doi: 10.1002/(sici)1097-0142(19970115)79:2<390::aid-cncr23>3.0.co;2-v.

DOI:10.1002/(sici)1097-0142(19970115)79:2<390::aid-cncr23>3.0.co;2-v

PMID:9010113

Abstract

BACKGROUND

Non-Hodgkin's lymphoma (NHL) originating in mucosa-associated lymphoid tissue (MALT) is supposed to have different clinical behavior from lymph node NHL. To test this hypothesis, the authors compared data of gastric NHL patients with lymph node NHL patients in a population-based registry for differences in clinical presentation and prognosis.

METHODS

Data from 1981-1989 on patients with primary gastric NHL (n = 109) and patients with primary lymph node NHL (n = 658) were retrieved from a Dutch population-based NHL registry. Patients were compared for stage distribution, involved sites, and survival. The prognostic value of grading lymphomas according to the malignancy grades of the Working Formulation for Clinical Usage was compared with the value of grading MALT NHLs as either low grade or high grade malignancies.

RESULTS

Patients with gastric NHL presented more often with localized disease. Stage IV patients had a higher rate of dissemination to other non-lymph node sites but less frequent localization in the bone marrow. The restricted pattern of dissemination was reflected in a significantly lower recurrence rate for gastric NHL. Gastric NHL patients had significantly better disease free survival than lymph node NHL patients (80% and 44% at 5 years, respectively; P < 0.001). In contrast, overall survival did not significantly differ between the two groups, and it appeared to depend on disease stage. Grading MALT lymphoma as either low grade (26%) or high grade (70%) malignancies did not provide better prognostic information than grading according to the Working Formulation for Clinical Usage (low 8%, intermediate 75%, high 9%).

CONCLUSIONS

Primary gastric NHL shows a restricted dissemination pattern, which gives support to the MALT lymphoma concept. Although this might explain the superior disease free survival observed for gastric NHL patients, it does not translate into better overall survival for these patients.

摘要

背景

起源于黏膜相关淋巴组织（MALT）的非霍奇金淋巴瘤（NHL）被认为具有与淋巴结NHL不同的临床行为。为验证这一假设，作者在一项基于人群的登记研究中比较了胃NHL患者和淋巴结NHL患者的数据，以观察临床表现和预后的差异。

方法

从荷兰一项基于人群的NHL登记研究中检索1981 - 1989年原发性胃NHL患者（n = 109）和原发性淋巴结NHL患者（n = 658）的数据。比较患者的分期分布、受累部位和生存率。将根据临床应用工作方案的恶性程度对淋巴瘤进行分级的预后价值与将MALT NHL分为低级别或高级别恶性肿瘤的分级价值进行比较。

结果

胃NHL患者更常表现为局限性疾病。IV期患者向其他非淋巴结部位的播散率较高，但骨髓受累频率较低。这种受限的播散模式反映在胃NHL的复发率显著较低。胃NHL患者的无病生存率明显高于淋巴结NHL患者（5年时分别为80%和44%；P < 0.001）。相比之下，两组的总生存率无显著差异，且似乎取决于疾病分期。将MALT淋巴瘤分为低级别（26%）或高级别（70%）恶性肿瘤，并不比根据临床应用工作方案分级（低级别8%，中级75%，高级9%）提供更好的预后信息。