非上呼吸消化道结外NK/T细胞淋巴瘤的不良预后因素分析

Analysis of adverse prognostic factors of non-upper aerodigestive tract extranodal NK/T-cell lymphoma

    摘要
  • 摘要:
      目的  分析非上呼吸消化道来源的结外NK/T细胞淋巴瘤（non-upper aerodigestive tract extranodal NK/T-cell lymphoma，NUAT-ENKTCL）的不良预后因素。
      方法  回顾性分析郑州大学第一附属医院2011年1月至2015年12月收治的20例NUAT-NKTCL患者临床资料，采用Kaplan-Meier法进行生存分析，应用Log-Rank法检验对EBER表达、年龄、性别、乳酸脱氢酶（lactic dehydrogenase，LDH）水平和治疗前外周血EBV-DNA拷贝数等进行单因素分析。
      结果  20例患者中，男女比为13:7。中位年龄为39（12~66）岁，其中≥60岁3例（15%）， < 60岁17例（85%）。Ann Arbor分期：Ⅰ、Ⅱ期8例（40%），Ⅲ、Ⅳ期12例（60%）。LDH水平升高12例（60%）。治疗前外周血EBV-DNA拷贝数增加11例（55%）。病变组织中EBER（+）13例（65%）。患者截至随访时间死亡4例，生存16例，中位总生存期（median overall survival，mOS）为15.4个月，中位无进展生存期（median progression free survival，mPFS）为8个月。完全缓解（complete response，CR）11例（55%），部分缓解（partial response，PR）5例（25%），客观缓解率（objective response rate，ORR）为80%。单因素分析显示年龄与预后呈显著相关性。
      结论  EBER的表达并不影响NUAT-ENKTCL患者的预后，年龄≥60岁患者预后较差。

     

    Abstract:
      Objective  To investigate the prognostic factors of non-upper aerodigestive tract extranodal NK/T- cell lymphoma (NUATNKTCL).
      Methods  Samples from twenty patients with NUAT-NKTCL, who were treated in The First Affiliated Hospital of Zhengzhou University between January 2011 and December 2015, were collected. The overall survival (OS) and progression-free survival (PFS) time of these patients were estimated by the Kaplan-Meier method. Through the log-rank test, the survival curves were compared among EBER expression, age, lactate dehydrogenase (LDH) level, EBV-DNA copies, and gender.
      Results  The male-female ratio of patients was 13:7. The median age was 39 years (range 12-66), with 3 patients above 60 years (15%) and the others below 60 years (85%). Forty percent of the patients were Ann-Arbor stage Ⅰ/Ⅱ and 60% of them were Ann-Arbor stage Ⅲ/Ⅳ. Twelve patients (60%) had a high level of LDH. Eleven patients had a high level of EBV-DNA copies in peripheral blood (55%) before treatment. Thirteen patients were EBER positive. Among the 20 patients, 4 patients died and 16 survived. The median OS was 15.4 months, and the median PFS was 8 months. Eleven patients received CR, 5 achieved PR while the ORR was 80%. The Log-rank test showed a significant association between age and prognosis (P=0.001).
      Conclusions  There was no correlation between EBER expression and prognosis of NUAT-NKTCL. Patients over 60 years of age had a poor prognosis.

     

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