唐加明, 陈安薇, 彭文明①, 秦自科②, 梁国华, 屈 谦. 108 例非霍奇金淋巴瘤预后因素分析[J]. 中国肿瘤临床, 2010, 37(5): 274-276. DOI: 10.3969/j.issn.1000-8179.2010.05.010
引用本文: 唐加明, 陈安薇, 彭文明①, 秦自科②, 梁国华, 屈 谦. 108 例非霍奇金淋巴瘤预后因素分析[J]. 中国肿瘤临床, 2010, 37(5): 274-276. DOI: 10.3969/j.issn.1000-8179.2010.05.010
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TANG Jiaming1, CHEN Anwei1, PENG Wenming2, QIN Zike3, LIANG Guohua1, QU Qian1. Analysis of Prognostic Factors of 108 Patients with Non-Hodgkin's Lymphoma[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2010, 37(5): 274-276. DOI: 10.3969/j.issn.1000-8179.2010.05.010
Citation: TANG Jiaming1, CHEN Anwei1, PENG Wenming2, QIN Zike3, LIANG Guohua1, QU Qian1. Analysis of Prognostic Factors of 108 Patients with Non-Hodgkin's Lymphoma[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2010, 37(5): 274-276. DOI: 10.3969/j.issn.1000-8179.2010.05.010
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108 例非霍奇金淋巴瘤预后因素分析

Analysis of Prognostic Factors of 108 Patients with Non-Hodgkin's Lymphoma

    摘要
  • 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 例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 × 109/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 × 109/L 患者70例，平均Hb为129.2 ± 17.5g/L，而ALC ≤1 × 109/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 × 109/L、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 × 109/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。

     

    Abstract: Objective:To analyze the prognostic factors of non-Hodgkin's lymphoma (NHL) and to investigate the prog -nostic value of peripheral blood absolute lymphocyte count (ALC) at admission for patients with NHL. Methods:Clinical fea -tures and follow-up data of 108 patients with pathologically confirmed NHL seen in our hospital between January2000and 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 48years. Before treatment, the Ann Arbor clinical classification showed that 61.1% of the cases were of stage Ⅰand 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 × 109/L. Hemoglobin (Hb) ≤110 g/L and B symptoms were seen in 29.6% and 26.9% of the patients. The mean Hb was129 .2 ± 17.5g/L in cases with ALC>1 × 109/L ( n=70) and 98.1 ± 20.6g/L in cases with ALC ≤1 × 109/L ( n=38), with a statistically significant difference be -tween 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 × 109/L, Hb ≤110 g/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 × 109/L, B symptoms and IPI ≥2 were statistically significant unfavorable prognostic factors for NHL. Conclusion:ALC and B symptoms may be prognostic factors indepen-dent of IPI for NHL. Evaluation of the prognosis with IPI, ALC, and B symptoms is of clinical value for individualized therapy of NHL patients.

     

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