弥漫大B细胞淋巴瘤患者临床特征及预后相关因素研究
摘要
目的：探讨中国患者弥漫大B细胞淋巴瘤(DLBCL)的临床特点,回顾分析临床分期、血清乳酸脱氢酶(LDH)、血清β2-微球蛋白水平与DLBCL预后的关系。
方法：收集2003年3月-2008年11月浙江大学医学院附属第一医院病理科确诊为DLBCL的病例101例,有完整临床资料并完成随访的病例85例。所有病例按WH02001分类标准进行病理分型,用电话方式对所有的患者或其家属随访。收集DLBCL患者初发时血清β2-微球蛋白,LDH水平,临床分期等指标,分析其与患者生存期之间的关系。
结果：1、101例患者中,年龄13-78岁,中位年龄为49岁,男女比例为1.29：1,其中大于50岁者50例,占49.5%。46例(45.5%)患者首发于颈部或腹股沟淋巴结,23例(22.8%)例首发于胃肠道,多位于回盲部和胃部,有B症状者32例,占31.7%。2、85例可追踪随访的病例中死亡36例,死亡率42.4%,中位随访时间31月；其中17例在诊断后1年内死亡,占20.0%。3、血清LDH增高组生存时间较正常组短,死亡率较正常组明显增高,有统计学意义(P<0.05)。血清62-微球蛋白增高与分期相关,临床分期Ⅲ,Ⅳ期患者β2-微球蛋白水平明显高于Ⅰ,Ⅱ组,有统计学意义(P<0.05)。
结论：DLBCL患者,血清LDH增高者提示预后较差,且增高水平与分期相关。血清β2-微球蛋白水平与生存时间及分期有明显相关性。
Objective:To explore the clinical features of diffuse large B-cell lymphoma(DLBCL) in Chinese patients, and analyze the prognositic significance of Ann Arbor stages, serum lactate dehydrogenase(LDH),β2-microglobulin(β2-MG) with DLBCL cases.
Methods:One hundred and one patients who were diagnosed as DLBCL by pathology form March 2003 to November 2008 in First Affiliated Hospital, College of Medicine, Zhejiang University were enrolled and analyzed retrospectively. All of the cases were determined according to WHO 2001 classification, and followed up by telephone. Collected the level of serum LDH,β2-MG, and clinical stages, the patients were analyzed the relation between these parameters and survival.
Results:1) Firstly, among the 101 de novo DLBCL patients, the average age was 49, the ratio of male to female Was 1.29:1. Fifty patients were older than 50, accounting for 49.5%. Forty-six cases (45.5%) were found firstly in lymph node and 23 cases (22.8%) in the gastrointestine, especially in ileocecus and stomach. Thirty-two patients had B symptoms, accounting for 31.7%.2) Among 85 followed-up cases during the median 31-month follow-up,36 (42.4%) died of DLBCL;and 17 cases (20%) passed away in the first year after diagnosis.3) In this study, the rate of mortality was significantly higher in elevated LDH group than in normal group. On the other hand, the overal survival rate was lower in the abnormal group of LDH level (P<0.05).4) The serumβ2-MG level were significantly higher in the cases with stage III and IV than stageⅠandⅡ(P＜0.05).
Conclusions:1) In DLBCL cases, the elevated LDH level could be a poor prognostic factor and be associated with clinical staging.2) The level of serumβ2-MG might also be associated with clinical staging and survival.
方法：收集2003年3月-2008年11月浙江大学医学院附属第一医院病理科确诊为DLBCL的病例101例,有完整临床资料并完成随访的病例85例。所有病例按WH02001分类标准进行病理分型,用电话方式对所有的患者或其家属随访。收集DLBCL患者初发时血清β2-微球蛋白,LDH水平,临床分期等指标,分析其与患者生存期之间的关系。
结果：1、101例患者中,年龄13-78岁,中位年龄为49岁,男女比例为1.29：1,其中大于50岁者50例,占49.5%。46例(45.5%)患者首发于颈部或腹股沟淋巴结,23例(22.8%)例首发于胃肠道,多位于回盲部和胃部,有B症状者32例,占31.7%。2、85例可追踪随访的病例中死亡36例,死亡率42.4%,中位随访时间31月；其中17例在诊断后1年内死亡,占20.0%。3、血清LDH增高组生存时间较正常组短,死亡率较正常组明显增高,有统计学意义(P<0.05)。血清62-微球蛋白增高与分期相关,临床分期Ⅲ,Ⅳ期患者β2-微球蛋白水平明显高于Ⅰ,Ⅱ组,有统计学意义(P<0.05)。
结论：DLBCL患者,血清LDH增高者提示预后较差,且增高水平与分期相关。血清β2-微球蛋白水平与生存时间及分期有明显相关性。
Objective:To explore the clinical features of diffuse large B-cell lymphoma(DLBCL) in Chinese patients, and analyze the prognositic significance of Ann Arbor stages, serum lactate dehydrogenase(LDH),β2-microglobulin(β2-MG) with DLBCL cases.
Methods:One hundred and one patients who were diagnosed as DLBCL by pathology form March 2003 to November 2008 in First Affiliated Hospital, College of Medicine, Zhejiang University were enrolled and analyzed retrospectively. All of the cases were determined according to WHO 2001 classification, and followed up by telephone. Collected the level of serum LDH,β2-MG, and clinical stages, the patients were analyzed the relation between these parameters and survival.
Results:1) Firstly, among the 101 de novo DLBCL patients, the average age was 49, the ratio of male to female Was 1.29:1. Fifty patients were older than 50, accounting for 49.5%. Forty-six cases (45.5%) were found firstly in lymph node and 23 cases (22.8%) in the gastrointestine, especially in ileocecus and stomach. Thirty-two patients had B symptoms, accounting for 31.7%.2) Among 85 followed-up cases during the median 31-month follow-up,36 (42.4%) died of DLBCL;and 17 cases (20%) passed away in the first year after diagnosis.3) In this study, the rate of mortality was significantly higher in elevated LDH group than in normal group. On the other hand, the overal survival rate was lower in the abnormal group of LDH level (P<0.05).4) The serumβ2-MG level were significantly higher in the cases with stage III and IV than stageⅠandⅡ(P＜0.05).
Conclusions:1) In DLBCL cases, the elevated LDH level could be a poor prognostic factor and be associated with clinical staging.2) The level of serumβ2-MG might also be associated with clinical staging and survival.
引文
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