原发于淋巴结内、外弥漫大B细胞淋巴瘤预后影响因素分析
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摘要
目的分析原发于结内、外弥漫大B细胞淋巴瘤(DLBCL)预后影响因素。方法 DLBCL患者137例,其中结内DLBCL 70例、结外DLBCL 67例,采用单因素分析法和Cox模型多因素预后分析法分析结内、外DLBCL患者预后影响因素。结果单因素分析显示,结内DLBCL的分期、B组症状、贫血、淋巴细胞绝对数、白蛋白、LDH、ECOG评分、IPI评分、病理分型、治疗方案是其预后影响因素,结外者的贫血、LDH、ECOG评分、治疗方案是其预后影响因素;多因素分析显示,结内DLBCL的治疗方案、B组症状是其预后独立危险因素,结外DLBCL的ECOG评分、LDH是其预后独立危险因素。结论治疗方案与B组症状是结内DLBCL患者的独立危险因素,ECOG与LDH是结外DLBCL患者的独立危险因素。
Objective To analyze the prognostic factors of diffuse large B-cell lymphoma(DLBCL) of nodal and extranodal primary origin.Methods There were 137 patients with DLBCL,including 70 patients with nodal DLBCL(N-DLBCL) and 67 patients with extranodal DLBCL(EN-DLBCL).The clinical characteristics of the two groups were compared.Kaplan-Meier survival analysis and Cox model multivariate prognostic analysis were used to analyze the prognostic factors of patients with N-DLBCLand EN-DLBCL.Results Univariate analysis indicated that Ann Arbor staging,B-symptoms,anemia,peripheral blood absolute lymphocyte count,albumin,lactate dehydrogenase(LDH),ECOG score,IPI score,pathological type,and therapeutic regimen were prognostic factors for N-DLBCL;the anemia,LDH,ECOG score,and therapeutic regimen were prognostic factors for EN-DLBCL.Multivariate analysis showed that the therapeutic regimen and B-symptoms were independent prognostic factors for N-DLBCL,while ECOG score and LDH were independent prognostic factors for EN-DLBCL.Conclusion The therapeutic regimen and B-symptoms are independent prognostic factors of N-DLBCL,while ECOG score and LDH are independent prognostic factors of EN-DLBCL.
Objective To analyze the prognostic factors of diffuse large B-cell lymphoma(DLBCL) of nodal and extranodal primary origin.Methods There were 137 patients with DLBCL,including 70 patients with nodal DLBCL(N-DLBCL) and 67 patients with extranodal DLBCL(EN-DLBCL).The clinical characteristics of the two groups were compared.Kaplan-Meier survival analysis and Cox model multivariate prognostic analysis were used to analyze the prognostic factors of patients with N-DLBCLand EN-DLBCL.Results Univariate analysis indicated that Ann Arbor staging,B-symptoms,anemia,peripheral blood absolute lymphocyte count,albumin,lactate dehydrogenase(LDH),ECOG score,IPI score,pathological type,and therapeutic regimen were prognostic factors for N-DLBCL;the anemia,LDH,ECOG score,and therapeutic regimen were prognostic factors for EN-DLBCL.Multivariate analysis showed that the therapeutic regimen and B-symptoms were independent prognostic factors for N-DLBCL,while ECOG score and LDH were independent prognostic factors for EN-DLBCL.Conclusion The therapeutic regimen and B-symptoms are independent prognostic factors of N-DLBCL,while ECOG score and LDH are independent prognostic factors of EN-DLBCL.
引文
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[15]韩颖,秦燕,何小慧,等.370例晚期弥漫大b细胞淋巴瘤的临床特征和预后分析[J].中华肿瘤杂志,2018,40(6):456-461.
[16]张克娟,杨明珍.免疫学标记在弥漫大B细胞淋巴瘤中的预后意义[J].安徽医科大学学报,2016,51(10):1495-1499.
[17]黄凤祥,刘畅,吕桂阳,等.原发性胃弥漫大B细胞淋巴瘤生存情况及预后影响因素分析[J].医学临床研究,2018,35(5):853-855.
[18]张甜甜,高大林,李少玲,等.原发睾丸弥漫性大B细胞淋巴瘤的预后影响因素分析[J].山东医药,2015,52(32):48-50.
[19]郑艳彬,何鸿鸣,杨瑜,等.56例原发性胃弥漫大B细胞淋巴瘤患者的临床预后因素分析[J].癌症进展,2015(5):545-549.
[2]刘卫平,张文燕,赵莎.结外淋巴瘤概念及病理诊断[J].西部医学,2016,28(11):1485-1488.
[3]Wang XM,Bassig BA,Wen JJ,et al.Clinical analysis of 1629newly diagnosed malignant lymphomas in current residents of Sichuan province,China[J].Hematol Oncol,2016,34(4):193-199.
[4]王聪,袁长吉,何华,等.不同原发部位弥漫大B细胞淋巴瘤临床病理特点及预后比较[J].白血病·淋巴瘤,2014,23(4):208-212.
[5]陈燕,崔自强,王华,等.弥漫性大B细胞淋巴瘤83例预后相关因素分析[J].临床与实验病理学杂志,2013,29(8):844-849,854.
[6]Wang C,Li W,Liu C,et al.Analysis of clinical and immunophenotypic features along with treatment outcomes of diffuse large Bcell lymphoma patients,based on the involvement of nodal or extranodal primary sites[J].Blood Cells Mol Dis,2016,57:42-49.
[7]Sabattini E,Bacci F,Sagramoso C,et al.WHO classification of tumours of haematopoietic and lymphoid tissues in 2008:an overview[J].Pathologica,2010,102(3):83-87.
[8]Al-Humood SA,Al-Qallaf AS,Alshemmari SH,et al.Genotypic and phenotypic differences between nodal and extranodal diffuse large B-Cell lymphomas[J].J Histochem Cytochem,2011,59(10):918-931.
[9]胡萍萍,王尧坤,项静静,等.弥漫大b细胞淋巴瘤的研究进展[J].浙江临床医学,2017,19(9):1746-1748.
[10]杨萍,甄敬飞,庞萌,等.原发生殖系统弥漫大B细胞淋巴瘤患者临床及生存分析[J].中华医学杂志,2018,98(20):1593-1596.
[11]Yang P,Jing HM,Zhao W,et al.Analysis of survival and treatment outcome of young patients with high-risk diffuse large B cell lymphoma[J].Zhonghua Yi Xue Za Zhi,2017,97(32):2485-2490.
[12]Ochi Y,Kazuma Y,Hiramoto N,et al.Utility of a simple prognostic stratification based on platelet counts and serum albumin levels in elderly patients with diffuse large B cell lymphoma[J].Ann Hematol,2017,96(1):1-8.
[13]Gutiérrez-García G,Colomo L,Villamor N,et al.Clinico-biological characterization and outcome of primary nodal and extranodal diffuse large B-cell lymphoma in the rituximab era[J].Leuk Lymphoma,2010,51(7):1225-1232.
[14]Han Y,Qin Y,He XH,et al.Retrospective analysis of the clinical features and prognostic factors of 370 patients with advancedstage diffuse large B-cell lymphoma[J].Zhonghua Zhong Liu Za Zhi,2018,40(6):456-461.
[15]韩颖,秦燕,何小慧,等.370例晚期弥漫大b细胞淋巴瘤的临床特征和预后分析[J].中华肿瘤杂志,2018,40(6):456-461.
[16]张克娟,杨明珍.免疫学标记在弥漫大B细胞淋巴瘤中的预后意义[J].安徽医科大学学报,2016,51(10):1495-1499.
[17]黄凤祥,刘畅,吕桂阳,等.原发性胃弥漫大B细胞淋巴瘤生存情况及预后影响因素分析[J].医学临床研究,2018,35(5):853-855.
[18]张甜甜,高大林,李少玲,等.原发睾丸弥漫性大B细胞淋巴瘤的预后影响因素分析[J].山东医药,2015,52(32):48-50.
[19]郑艳彬,何鸿鸣,杨瑜,等.56例原发性胃弥漫大B细胞淋巴瘤患者的临床预后因素分析[J].癌症进展,2015(5):545-549.