[Current status and progress of prognostic evaluation in marginal zone lymphoma]

Area of Science:

• Hematology
• Oncology
• Genetics

Background:

• Marginal zone lymphoma (MZL) is a heterogeneous indolent B-cell non-Hodgkin lymphoma.
• Current risk stratification using histology, stage, and MZL-IPI has limited differentiation power, especially for intermediate-risk disease.
• Existing methods fail to fully capture the biological heterogeneity of MZL.

Purpose of the Study:

• To review current prognostic factors for Marginal Zone Lymphoma (MZL).
• To highlight the limitations of existing prognostic tools in MZL.
• To propose a future direction for improved MZL risk stratification.

Main Methods:

• Systematic review of current prognostic factors in MZL.
• Analysis of molecular genetic findings, including gene mutations and chromosomal abnormalities.
• Evaluation of imaging techniques such as 18F-FDG PET/CT and novel tracers like CXCR4 PET/CT.

Main Results:

• Molecular genetic markers (e.g., TP53 mutations) and chromosomal abnormalities (t(11;18), 7q deletion) show significant prognostic impact.
• TP53 mutations are linked to histological transformation and poor outcomes.
• Novel imaging tracers (CXCR4 PET/CT) and imaging omics offer improved lesion detection and insights into tumor heterogeneity, surpassing limitations of 18F-FDG PET/CT.

Conclusions:

• Current prognostic factors for MZL are insufficient to address disease heterogeneity.
• Integrating clinical, molecular, imaging, and multi-omics data is crucial for advanced risk stratification.
• Artificial intelligence can facilitate the development of multidimensional prognostic models for personalized MZL treatment.