边缘区淋巴瘤的发病机制、诊断、治疗及预后研究进展。

IF 4.7 2区 医学 Q2 ONCOLOGY
Qingyang Zhang, Wenzhe Yan, Heng Li, Hongling Peng
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引用次数: 0

摘要

观点声明:边缘区淋巴瘤(MZL)是一种惰性b细胞非霍奇金淋巴瘤,由于其临床和预后异质性,需要个性化和适应性的治疗方法。我们认为治疗应强调考虑亚型、疾病负担、症状和可操作的遗传或环境因素(如感染或自身免疫性疾病)的平衡策略。对于低肿瘤负荷或弥散性疾病的无症状患者,考虑到MZL的惰性性质和过度治疗的风险,观察和等待方法仍然是合适的。相反,对于有症状或高负担的病例,建议早期干预化疗免疫治疗以有效控制疾病。对于局部疾病的诊断和治疗,手术仍然是必不可少的。结合分子谱分析和预后模型,如MZL-IPI和POD24,对决策和风险分层至关重要。检测幽门螺杆菌或丙型肝炎病毒等感染性病原体应成为标准做法,因为根除治疗为特定患者提供了一种有针对性、毒性较小且有效的选择。随着对信号通路失调和肿瘤微环境的不断了解,我们预计新的靶向治疗和联合治疗方案将进一步改善结果。我们提倡在诊断时进行分子检测,以确定可操作的生物标志物,特别是对于难治性或复发性疾病的患者。最后,MZL的管理需要根据不断变化的疾病特征进行警惕的随访和调整。治疗决策应综合患者偏好、临床背景和最新证据,以最大限度地提高生存率,同时保持生活质量。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Advances in the Pathogenesis, Diagnosis, Treatment, and Prognosis of Marginal Zone Lymphoma.

Opinion statement: The management of marginal zone lymphoma (MZL), an indolent B-cell non-Hodgkin lymphoma, requires a personalized and adaptive approach due to its clinical and prognostic heterogeneity. We believe treatment should emphasize a balanced strategy considering the subtype, disease burden, symptoms, and actionable genetic or environmental factors, such as infections or autoimmune diseases. For asymptomatic patients with low tumor burden or disseminated disease, a watch-and-wait approach remains appropriate, given MZL's indolent nature and the risks of overtreatment. Conversely, for symptomatic or high-burden cases, early intervention with chemoimmunotherapy is recommended for effective disease control. Surgery remains essential for both diagnosis and the treatment of localized disease. Incorporating molecular profiling and prognostic models, such as MZL-IPI and POD24, is crucial for decision-making and risk stratification. Testing for infectious agents like Helicobacter pylori or Hepatitis C virus should be standard practice, as eradication therapy offers a targeted, less toxic, and effective option in select patients. With ongoing advancements in understanding dysregulated signaling pathways and the tumor microenvironment, we anticipate novel targeted therapies and combination regimens will further improve outcomes. We advocate for molecular testing at diagnosis to identify actionable biomarkers, particularly for patients with refractory or relapsed disease. Finally, MZL management requires vigilant follow-up with adjustments based on evolving disease features. Treatment decisions should integrate patient preferences, clinical context, and the latest evidence to maximize survival while preserving quality of life.

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来源期刊
CiteScore
7.10
自引率
0.00%
发文量
113
审稿时长
>12 weeks
期刊介绍: This journal aims to review the most important, recently published treatment option advances in the field of oncology. By providing clear, insightful, balanced contributions by international experts, the journal intends to facilitate worldwide approaches to cancer treatment. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as endocrine tumors, lymphomas, neuro-oncology, and cancers of the breast, head and neck, lung, skin, gastrointestinal tract, and genitourinary region. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. We also provide commentaries from well-known oncologists, and an international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research.
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