摘要
目的探讨乙肝病毒（hepatitis B virus,HBV）感染弥漫大B细胞淋巴瘤（diffuse large B-cell lymphoma,DLBCL）患者的临床特征和预后。方法回顾性分析235例初治DLBCL患者,分为HBs Ag阳性组76例和HBs Ag阴性组159例,对两组患者的临床特征、化疗期间肝功能损害及总生存情况比较分析。结果与HBs Ag阴性组比较,HBs Ag阳性DLBCL患者发病中位年龄较小（47岁vs 58岁,P〈0.01）,脾脏和肝脏受累多见（26.3%vs 15.1%,P=0.039;11.8%vs 4.4%,P=0.034）,化疗期间肝功能损害发生率较高（47.4%vs 26.2%,P=0.001）。HBs Ag阳性组中位总生存（overall survival,OS）为48月,3年OS为64.1%;HBs Ag阴性组中位OS为42月,3年OS为61.7%,差异无统计学意义（χ^2=0.988,P=0.320）;无进展时间（progression-free survival,PFS）差异亦无统计学意义（χ^2=2.658,P=0.103）。采用Cox回归多因素分析,HBs Ag阳性DLBCL患者的不良预后因素包括年龄〉60岁、B症状和肝脏受累,肝功能损害不影响其总生存。结论 HBs Ag阳性DLBCL患者发病年龄较轻,肝脾受累多见,且化疗相关肝功能损害发生率较高,但在总生存和无进展生存方面与HBs Ag阴性患者无显著差异。
Objective To investigate the clinical characteristics and prognosis of HBs Ag-positive patients with diffuse large B-cell lymphoma（ DLBCL）. Methods The clinical data of 235 patients with DLBCL were retrospectively analyzed,including 76 cases with positive HBs Ag and 159 cases with negative HBs Ag. The clinical features,liver injury during chemotherapy and overall survival rate were compared between two groups. Results Compared with the HBs Ag-negative group,the HBs Ag-positive DLBCL group displayed a younger median onset age（ 47 years vs 58 years,P〈0. 01）,more spleen involvement（26. 3% vs 15. 1%,P = 0. 039）,more liver involvement（11. 8% vs 4. 4%,P = 0. 034）,and higher rates of liver function damage during chemotherapy（47. 4% vs 26. 2%,P = 0. 001）. The median overall survival（ OS）and 3-year survival rate in HBs Ag-positive and HBs Ag-negative groups were 48 months,42 months and 64. 1%,61. 7%,respectively; there was no significant difference between two groups（ χ^2= 0. 988,P = 0. 320）. The progression-free survival（PFS） rates of two groups also had no significant difference（χ^2= 2. 658,P = 0. 103）. Cox regression analysis showed that age 〉60 years,positive B symptoms and liver involvement were adverse prognostic factors for HBs Ag-positive DLBCL patients,whereas hepatic dysfunction had no influence on overall survival. Conclusion HBs Ag-positive DLBCL patients have earlier onset,more liver and spleen involvement,and higher rates of hepatic dysfunction during chemotherapy. However,the OS and PFS of HBs Ag-positive DLBCL patients are similar to those of HBs Ag-negative patients.
出处
《实用肿瘤杂志》
CAS
2016年第2期163-169,共7页
Journal of Practical Oncology
关键词
淋巴瘤
大B细胞
弥漫性
肝炎病毒
乙型
感染
预后
肝功能不全
回顾性研究
lymphoma
large B-cell
diffuse
hepatitis B virus
infection
prognosis
hepatic insufficiency
retrospective studies
