[Analysis and reflections on the current status of diagnosis and treatment of marginal zone lymphoma].

Abstract

The current study aimed to understand the current status and problems of marginal zone lymphoma (MZL) in the diagnosis and treatment of hospitals at all levels in China. A multi-center questionnaire survey was conducted in a number of medical institutions across the country. A combination of online questionnaire survey and face-to-face interview was adopted. (1)Pathologists paid more attention than clinicians to distinguish MALT from chronic inflammation (86.3% vs 32.1%, P<0.01) and plasma cell tumor (51.8% vs 23.1%, P<0.01). A total of 21% pathologists never performed B-cell gene rearrangement, 67.6% of clinicians and 69.0% of pathologists would not recommend splenic puncture to diagnose SMZL.(2)In terms of treatment indications, 40.0% of clinicians mistakenly believed that stage Ⅲ-Ⅳ was also a treatment indication. Seventy percent of clinicians reported confusion about treatment indications. (3) In staging and efficacy evaluation, 63.3% of physicians performed PET-CT testing for patients, mainly for resolving clinical staging (89.0%), identifying histologically transformation (79.6%), and determining the site of radiotherapy or biopsy (66.2%). (4) In terms of treatment choice, only 32.2% of patients with indications were recommended for radiotherapy, and the proportion of hematologists choosing radiotherapy was significantly lower than that of oncologists (42.6% vs 71.7%, P<0.01); In the anti-HP indications, 53.1% of physicians will perform anti-HP therapy regardless of Hp positive or not; For advanced MZL, first-line immunochemotherapy was selected by 62.7% of clinicians, compared with 37.3% for targeted therapy. (5)15.3% of clinicians believed that the current prognostic evaluation system could not guide the selection of treatment options after initial treatment and recurrence. At present, there are still some cognitive deviations in the disease cognition and treatment indication of MZL among clinicians at all levels of hospitals in China. Likewise, there are still many unmet needs in MZL staging, efficacy evaluation, treatment selection and prognosis evaluation.