Clinicopathologic Characteristics Associated with Prognosis in Ocular Extranodal Marginal Zone B Cell Lymphoma
Abstract
:1. Introduction
2. Materials and Methods
2.1. Clinical Features
2.2. Histological Features
2.2.1. Confluent or Nonconfluent
2.2.2. Plasma Cells
2.2.3. Sclerosis
2.2.4. Lymphoepithelial Lesion
2.2.5. Large Cell Change
2.2.6. Lymphovascular Invasion
2.3. Immunohistochemistry
2.3.1. Ki-67 Labeling Index
2.3.2. IgG4/IgG Ratio
2.4. IgH Gene Rearrangement Study
2.5. Treatment and Follow-Up
2.6. Statistical Analysis
3. Results
3.1. Clinicopathologic Characteristics of Patients
3.2. Clinicopathologic Characteristics and Risk Factors for Non-CR in Conjunctiva and Non-Conjunctiva Groups
3.3. Clinicopathologic Characteristics in Recurred Patients
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variable | Response, n (%) | p-Value | ||
---|---|---|---|---|
Total (n = 48) | CR (n = 33) | Non-CR (n = 15) | ||
Age | 52.08 (14.95) | 52.36 (14.60) | 51.47 (16.19) | 0.850 |
Sex, n (%) | 0.367 | |||
Male | 27 (56.3%) | 20 (60.6%) | 7 (46.7%) | |
Female | 21 (43.8%) | 13 (39.4%) | 8 (53.3%) | |
Laterality, n (%) | 0.857 | |||
Unilateral | 36 (75.0%) | 25 (75.8%) | 11 (73.3%) | |
Bilateral | 12 (25.0%) | 8 (24.2%) | 4 (26.7%) | |
T stage | 1.000ᵇ | |||
T1 | 22 (45.8%) | 15 (45.5%) | 7 (46.7%) | |
T2 | 23 (47.9%) | 15 (45.5%) | 8 (53.3%) | |
T3 | 2 (4.2%) | 2 (6.1%) | 0 (0%) | |
T4 | 1 (2.1%) | 1 (3.0%) | 0 (0%) | |
Management | 0.043 ᵇ* | |||
Observation | 15 (31.3%) | 7 (21.2%) | 8 (53.3%) | |
Treatment | 33 (66.8%) | 26 (78.8%) | 7 (46.7%) | |
Radiotherapy | 31 (64.6%) | 24 (72.7%) | 7 (46.7%) | |
Chemotherapy | 2 (4.2%) | 2 (6.1%) | 0 (0%) | |
RT dose (Gy) (n = 23, 7) | 26.64 (3.38) | 26.61 (3.54) | 26.74 (3.08) | 0.635 ᵃ |
SUVmax (n = 32, 12) | 2.55 (1.42) | 2.52 (1.30) | 2.64 (1.78) | 0.822 ᵃ |
SUVmax (post-RT) (n = 14, 4) | 2.27 (0.99) | 1.98 (0.77) | 3.27 (1.13) | 0.016 * |
LDH (U/L) (n = 33, 13) | 252.48 (82.65) | 237.33 (75.51) | 290.91 (90.44) | 0.042 ᵃ* |
ß2MG >2.19 (mg/L) (n = 31, 13) | 6 (13.6%) | 5 (16.1%) | 1 (7.7%) | 0.457 |
CRP >0.50 (mg/dL) (n = 33, 13) | 2 (4.3%) | 1 (3.0%) | 1 (7.7%) | 0.490 ᵇ |
Serum IgG4 >135 (mg/dL)(n = 22, 6) | 7 (25.0%) | 4 (18.2%) | 3 (50.0%) | 0.144 ᵇ |
Failure-free survival (months) | 38.00 (21.67) | 40.58 (21.83) | 32.33 (20.93) | 0.222 |
Follow-up period (month) | 43.33 (24.35) | 40.58 (21.83) | 49.40 (29.06) | 0.249 |
Variable | Response, n (%) | p-Value | ||
---|---|---|---|---|
Total (n = 48) | CR (n = 33) | Non-CR (n = 15) | ||
Histologic pattern | 0.151 | |||
Confluent | 10 (20.8%) | 5 (15.2%) | 5 (33.3%) | |
Nonconfluent | 38 (79.2%) | 28 (84.8%) | 10 (66.7%) | |
Plasma cells | 0.531 | |||
Absent | 17 (35.4%) | 13 (39.4%) | 4 (26.7%) | |
Patchy | 20 (41.7%) | 12 (36.4%) | 8 (53.3%) | |
Sheet | 11 (22.9%) | 8 (24.2%) | 3 (20.0%) | |
Sclerosis | 0.306 | |||
Absent | 16 (33.3%) | 9 (27.3%) | 7 (46.7%) | |
Mild | 12 (25.0%) | 10 (30.3%) | 2 (13.3%) | |
Moderate to severe | 20 (41.7%) | 14 (42.4%) | 6 (40.0%) | |
Lymphoepithelial lesion | 31 (64.6%) | 20 (60.6%) | 11 (73.3%) | 0.393 |
Large cell change | 4 (8.3%) | 2 (6.1%) | 2 (13.3%) | 0.579 ᵇ |
Lymphovascular invasion | 46 (95.8%) | 31 (93.9%) | 15 (100.0%) | 1.000 ᵇ |
Ki-67 | 10.44 (10.69) | 9.40 (9.53) | 11.53 (13.21) | 0.588 ᵃ |
IgG4/IgG ≥ 0.4 (n = 33, 13) | 4 (8.7%) | 4 (12.1%) | 0 (0.0%) | 0.313 ᵇ |
IgH rearrangement (n = 26, 10) | 0.900 | |||
Monoclonal | 15 (41.7%) | 11 (43.3%) | 4 (40.0%) | |
Polyclonal | 21 (58/3%) | 15 (57.7%) | 6 (60.0%) |
Variable | Odd Ratio | 95% CI | p-Value |
---|---|---|---|
LDH >225 U/L | 4.142 | 0.807–21.269 | 0.089 |
Ki-67 ≥ 5% | 0.678 | 0.133–3.447 | 0.639 |
Treatment (RT or CT with immunotherapy) | 7.301 | 1.273–41.862 | 0.026 * |
SUVmax | 1.349 | 0.769–2.365 | 0.296 |
Conjunctival MALT Lymphoma (n = 22) | Non-Conjunctival MALT Lymphoma (n = 26) | |||||
---|---|---|---|---|---|---|
Variable | CR (n = 15) | Non-CR (n = 7) | p-Value | CR (n = 18) | Non-CR (n = 8) | p-Value |
Histologic pattern | 0.145 ᵇ | 1.000 ᵇ | ||||
Confluent | 3 (20.0%) | 4 (57.1%) | 2 (11.1%) | 1 (12.5%) | ||
Nonconfluent | 12 (80.0%) | 3 (42.9%) | 16 (88.9%) | 7 (87.5%) | ||
Plasma cells | 0.310 ᵇ | 0.704 ᵇ | ||||
Absent | 5 (33.3%) | 0 (0.0%) | 8 (44.4%) | 4 (50.0%) | ||
Patchy | 5 (33.3%) | 4 (57.1%) | 7 (38.9%) | 4 (50.0%) | ||
Sheet | 5 (33.3%) | 3 (42.9%) | 3 (16.7%) | 0 (0.0%) | ||
Sclerosis | 0.165 ᵇ | 0.856 ᵇ | ||||
Absent | 6 (40.0%) | 5 (71.4%) | 3 (16.7%) | 2 (25.0%) | ||
Mild | 6 (40.0%) | 0 (0.0%) | 4 (22.2%) | 2 (25.0%) | ||
Moderate to severe | 3 (20.0%) | 2 (28.6%) | 11 (61.1%) | 4 (50.0%) | ||
Lymphoepithelial lesion | 14 (93.3%) | 7 (100.0%) | 1.000 ᵇ | 6 (33.3%) | 4 (50.0%) | 0.664 ᵇ |
Large cell change | 0 (0%) | 2 (28.6%) | 0.091 ᵇ | 2 (11.1%) | 0 (0.0%) | 1.000 ᵇ |
Lymphovascular invasion | 13 (86.7%) | 7 (100.0%) | 1.000 ᵇ | 18 (100.0%) | 8 (100.0%) | |
Ki-67 | 9.73 (12.08) | 15.00 (15.73) | 0.722 ᵃ | 10.11 (7.12) | 8.50 (10.69) | 0.221 ᵃ |
IgG4/IgG ≥ 0.4 (n = 15, 6 and n = 18, 7) | 1 (6.3%) | 0 (0%) | 1.000 ᵇ | 3 (16.7%) | 0 (0.0%) | 0.534 ᵇ |
Laterality | 0.376 ᵇ | 0.529 ᵇ | ||||
Unilateral | 10 (66.7%) | 3 (42.9%) | 15 (83.3%) | 8 (100.0%) | ||
Bilateral | 5 (33.3%) | 4 (57.1%) | 3 (16.7%) | 0 (0.0%) | ||
Management | 0.165 ᵇ | 0.086 ᵇ | ||||
Observation | 7 (46.7%) | 6 (85.7%) | 0 (0.0%) | 2 (25.0%) | ||
Treatment | 8 (53.3%) | 1 (14.3%) | 18 (100.0%) | 6 (75.0%) | ||
Radiotherapy | 8 (53.3%) | 1 (14.3%) | 16 (88.9%) | 6 (75.0%) | ||
Chemotherapy | 0 (0.0%) | 0 (0.0%) | 2 (11.1%) | 0 (0.0%) | ||
SUVmax (n = 14, 6 and n = 18, 6) | 1.86 (0.37) | 1.75 (0.25) | 0.533 | 3.03 (1.52) | 3.53 (2.24) | 0.617 ᵃ |
SUVmax (post-RT) (n = 3, 0 and n = 11, 4) | 1.23 (1.07) | 2.18 (0.58) | 3.27 (1.13) | 0.026 * | ||
LDH (U/L) (n = 15, 6 and n = 18, 7) | 257.13 (94.62) | 291.33 (110.49) | 0.483ᵃ | 220.83 (52.20) | 290.57 (78.64) | 0.037 ᵃ* |
ß2MG > 2.19 (mg/L) (n = 13, 6 and n = 18, 7) | 3 (23.1%) | 0 (0.0%) | 0.200 | 2 (11.1%) | 1 (14.3%) | 0.826 |
Failure-free survival (month) | 44.87 (28.63) | 30.00 (24.68) | 0.252 | 37.00 (13.85) | 34.38 (18.55) | 0.691 |
Follow-up period (month) | 44.87 (28.12) | 42.71 (28.12) | 0.871 | 37.00 (13.85) | 55.25 (30.46) | 0.142 |
Patient # | Age/Sex | Primary Site | Treatment | Time to Relapse (Month) | Recur Site | Treatment | Outcome |
---|---|---|---|---|---|---|---|
1 | 32/M | Right conjunctiva | Observation (Antibiotics) | 80 | Right conjunctiva | Radiation | CR |
2 | 64/F | Left conjunctiva | Observation (Antibiotics) | 27 | Right conjunctiva | Observation (Excision) | CR |
3 | 35/F | Right conjunctiva | Observation (Excision) | 6 | Right conjunctiva | Radiotherapy | CR |
4 | 56/F | Left orbit | Radiotherapy | 35 | Both conjunctiva | NA | NA |
5 | 74/F | Left orbit | Radiotherapy | 9 | Right conjunctiva | Radiotherapy | CR |
6 | 47/F | Right lacrimal gland | Observation (Antibiotics) | 35 and 67 | Left eyelid and lung (multiple) | Obervation (Antibiotics) and Surgery | PR |
7 | 65/F | Right lacrimal gland | Radiotherapy | 48 and 26 | Right cheek and lung (DLBCL transformation) | Radiotherapy and surgery with chemotherapy and immunotherapy | CR |
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Choi, S.; Seo, M.; Park, S.H.; Jo, J.-C.; Chae, S.W.; Lee, J.-H.; Cha, H.J. Clinicopathologic Characteristics Associated with Prognosis in Ocular Extranodal Marginal Zone B Cell Lymphoma. Medicina 2022, 58, 818. https://0-doi-org.brum.beds.ac.uk/10.3390/medicina58060818
Choi S, Seo M, Park SH, Jo J-C, Chae SW, Lee J-H, Cha HJ. Clinicopathologic Characteristics Associated with Prognosis in Ocular Extranodal Marginal Zone B Cell Lymphoma. Medicina. 2022; 58(6):818. https://0-doi-org.brum.beds.ac.uk/10.3390/medicina58060818
Chicago/Turabian StyleChoi, Soyeon, Minjung Seo, Seol Hoon Park, Jae-Cheol Jo, Seoung Wan Chae, Ju-Hyang Lee, and Hee Jeong Cha. 2022. "Clinicopathologic Characteristics Associated with Prognosis in Ocular Extranodal Marginal Zone B Cell Lymphoma" Medicina 58, no. 6: 818. https://0-doi-org.brum.beds.ac.uk/10.3390/medicina58060818