摘要
目的：分析非霍奇金淋巴瘤（NHL）的预后相关因素，探讨NHL患者入院时外周血淋巴细胞绝对计数的预后价值。方法：回顾性分析2000年1月至2008年1月间108倒非霍奇金淋巴瘤患者的临床特征，结合随访资料，应用SPSS14．0软件进行统计分析，采用Kaplan-Meier法对生存概率进行评估，进一步采用Cox回归模型对单因素分析中有统计学意义的参数进行多因素分析。结果：108例非霍奇金淋巴瘤患者中，男女比例约为1．5：1，中位年龄48岁。治疗前，61．1％的患者为Ann ArborⅠ～Ⅱ期，ECOG体力状态（performance status）评分0-1的患者约占总数的93％，乳酸脱氢酶升高见于19．2％的患者，80．6％的患者属于IPI低危组。入院时外周血淋巴细胞绝对计数减少（ALC≤1×10^9／L）见于35．2％的患者，29．6％的患者有贫血（Hb≤110g／L），26．9％的患者伴有B症状。ALC〉1×10^9／L患者70例，平均Hb为129．2±17．5g／L，而ALC≤1×10^9／L患者38例，平均Hb为98．1±20．6g／L（P〈0．05）。全组患者中位随访时间2年，中位生存时间2．3年，2年和5年的总生存率分别为73-2％和39．6％。单因素生存分析显示，ALC≤1×10^7L、Hb≤110g/L、B症状及国际预后指数（IPI）≥2是NHL的不良预后因素。多因素分析显示，ALC≤1×10^9／L、B症状及IPI≥2是NHL的独立不良预后因素。结论：外周血淋巴细胞绝对计数及B症状是独立于国际预后指数之外的非霍奇金淋巴瘤预后指标。临床上，根据IPI及简单的临床参数ALC和B症状判断NHL预后．对实施个体化治疗可能具有更大实用价值。
Objective： To analyze the prognostic factors of non-Hodgkin＇s lymphoma （NHL） and to investigate the prognostic value of peripheral blood absolute lymphocyte count （ALC） at admission for patients with NHL. Methods： Clinical features and follow-up data of 108 patients with pathologically confirmed NHL seen in our hospital between January 2000 and January 2008 were reviewed. SPSS 14.0 package was used for statistical analysis. Kaplan-Meier was applied to assess the survival probability. All parameters statistically significant concluded by univariate analysis were then computed as co-variates for multivariate analysis with Cox regression model. Results： The ratio of males to females was approximately 1.5：1. The median age of patients was 48 years. Before treatment, the Ann Arbor clinical classification showed that 61.1% of the cases were of stage Ⅰ and Ⅱ. Approximately 93% of the patients had ECOG performance status （PS） score of 0-1 and 19.2% of the cases had elevated serum lactate dehydrogenase （LDH）. According to international prognosis index score, 80.6% of the patients were in a low risk group. At admission, 35.2% of the cases had ALC≤1× 10^9/L. Hemoglobin （Hb） ≤110g/L and B symptoms were seen in 29.6% and 26.9% of the patients. The mean Hb was 129.2±17.5g/L in cases with ALC〉 1 × 10^9/L （n=70） and 98.1＋20.6g/L in cases with ALC ≤ 1 × 10^9/L （n=38）, with a statistically significant difference between the two groups （P〈0.05）. With a median follow-up duration of 2 years, the median overall survival （OS） time was 2.3 years for all patients. The 2-year and 5-year OS rates were 73.2% and 39.6%, respectively. ALC ≤ 1 ×10^9/L, Hb≤ 110g/L, B symptoms and international prognostic index （IPI） ≥2 were statistically significant unfavorable prognostic factors for NHL revealed by univariate analysis. Multivariate analysis showed that ALC≤ 1 × 10^9/L, B symptoms and IPI ≥2 were statistically significant unfavorable prognostic factors for NHL. Conclusion： ALC and B symptoms may be prognostic factors independent of IPI for NHL. Evaluation of the prognosis with IPI, ALC, and B symptoms is of clinical value for individualized therapy of NHL patients.
出处
《中国肿瘤临床》
CAS
CSCD
北大核心
2010年第5期274-276,共3页
Chinese Journal of Clinical Oncology
