眼科 ›› 2012, Vol. 21 ›› Issue (5): 352-356.

• 论著 • 上一篇    下一篇

眼附属器MALT淋巴瘤的治疗及转化为弥漫性大B细胞淋巴瘤的危险因素

李玉珍  魏锐利  蔡季平  李由  程金伟   

  1. 200003 上海 第二军医大学附属长征医院眼科
  • 收稿日期:2012-02-09 出版日期:2012-09-25 发布日期:2012-09-28
  • 通讯作者: 魏锐利, Email: ruiliwei@gmail.com

The therapy and the risk factors for ocular adnexal mucosa-associated lymphoid tissue lymphoma transformation into DLBCL

 LI  Yu-Zhen, WEI  Rui-Li, CAI  Ji-Ping, LI  You, CHENG  Jin-Wei   

  1. Department of Ophthalmology, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China
  • Received:2012-02-09 Online:2012-09-25 Published:2012-09-28
  • Contact: WEI Rui-li, Email: ruiliwei@gmail.com

摘要: 目的 通过对眼附属器MALT淋巴瘤的不同治疗方式及影响其转化为弥漫性大B细胞淋巴瘤(DLBCL)危险因素的研究,以期能选择合适的手术方式,降低术后并发症的发生,提高生存率。设计 回顾性病例系列。研究对象 1997年1月至2010年6月上海第二军医大学附属长征医院眼科收治的79例病理确诊为IE期眼附属器MALT淋巴瘤患者。方法 回顾上述患者的临床表现、治疗方式(包括手术和放射治疗)及预后情况。手术方式包括全部切除和部分切除。预后情况主要观察患者的生存率、有无转化为弥漫性大B细胞淋巴瘤等。主要指标 临床表现、手术治疗、放射治疗、生存率、有无转化为弥漫性大B细胞淋巴瘤等。结果 所有病例均行手术治疗,其中全部切除58例,局部切除21例。所有患者均在手术后2~4周行眼局部放射治疗。5年总生存率86.0%,共有6例转化为DLBCL。放射治疗对眼附属器MALT淋巴瘤有较好的局部控制。患者双眼发病(P=0.0221)和对放射治疗的初始反应(P=0.0033)与肿瘤转化为DLBCL有相关性;而性别、年龄、发病部位、肿瘤大小及手术方式等因素对转化均无影响。结论 双眼发病和对放疗的初始反应与MALT淋巴瘤转化为DLBCL相关,而手术方式对转化无影响;根据不损伤眼部重要结构的原则来选择合适的手术方式,可降低术后并发症的发生。(眼科, 2012, 21: 352-356)

关键词: 眼附属器, 黏膜相关性淋巴样组织, 淋巴瘤, 弥漫性大B细胞淋巴瘤

Abstract: Objective To study therapy and the risk factors for ocular adnexal mucosa-associated lymphoid tissue (MALT) lymphoma transformation into diffuse large B cell lymphoma (DLBCL) so as to find suitable operation to reduce the incidence of postoperative complications as well as to improve the survival rate of patients. Design Retrospective case series. Participants 79 patients with biopsy-proven ocular adnexal MALT lymphoma in Changzheng hospital affiliated to Second Military Medical University from January 1997 to June 2010. Methods The clinical features, therapy (including surgery and radiation therapy) and prognosis of 79 patients were retrospectively reviewed. Surgery included complete excision and partial excision. Prognosis including survival rate and the risk factors for transformation to DLBCL was assessed. Main Outcome Measures The clinical features, surgery therapy, radiation therapy, survival rate, the risk factors for transformation to DLBCL. Results All cases were treated by operation. Fifty eight cases were treated with complete excision tumorectomy, while 21 cases with partial excision. All the patients received local radiotherapy on the eyes. There were 6 cases transformed from ocular adnexal MALT lymphoma into DLBCL. Radiotherapy was found to be benefitial for the controlling local symptoms of ocular adnexal MALT lymphoma. Bilateral onset (P=0.0221) and the initial reaction to radiotherapy (P=0.0033) were found to be correlated with the transformation from ocular adnexal MALT lymphoma into DLBCL. Nonetheless, gender, age, locations, tumor size and surgical procedures had no effects on the transformation. Conclusions Bilateral onset and the initial reaction to radiotherapy are correlated with the transformation from ocular adnexal MALT lymphoma into DLBCL. Nonetheless surgical procedures are of no effect on the transformation. However, selecting a suitable operation could reduce the incidence of postoperative complications. (Ophthalmol CHN, 2012, 21: 352-356)

Key words: ocular adnexa, mucosa-associated lymphoid tissue, lymphoma, diffuse large B cell lymphoma