摘要
目的探讨原发性胃弥漫大B细胞淋巴瘤(PG-DLBCL)患者的生存情况及其影响因素。方法回顾性分析184例PG-DLBCL患者的临床资料,记录患者的治疗方案,收集患者的临床资料及随访资料,采用KaplanMeier法绘制生存曲线并计算生存率。采用Cox比例风险回归模型对可能影响PG-DLBCL患者生存率的因素进行单因素及多因素分析。结果所有PG-DLBCL患者均随访5年,其中4例(2.2%)患者失访,125例(67.9%)患者至随访结束时仍然生存,其余55例(29.9%)患者均因PG-DLBCL进展死亡。Kaplan-Meier生存曲线显示,PGDLBCL患者的1、3、5年总生存率分别为88.3%、71.5%和67.9%。Cox单因素分析结果显示,Lugano分期、有无B症状、血红蛋白(HGB)水平、白蛋白(ALB)水平、乳酸脱氢酶(LDH)水平、β2微球蛋白水平、是否联用利妥昔单抗、有无幽门螺杆菌(Hp)感染对PG-DLBCL患者的预后有影响(P﹤0.05);而性别、年龄、细胞起源对PG-DLBCL患者的预后无影响(P﹥0.05)。Cox多因素分析结果显示,有无B症状、HGB水平、ALB水平、β2微球蛋白水平、有无Hp感染对PG-DLBCL患者的预后无影响(P﹥0.05);而Lugano分期、LDH水平和是否联用利妥昔单抗是PG-DLBCL患者预后的独立影响因素(RR=2.323、1.792、0.399,P﹤0.05)。结论 Lugano分期为Ⅲ~Ⅳ期、LDH水平升高是PG-DLBCL患者预后的独立危险因素,联用利妥昔单抗可以提高患者的生存率。
Objective To explore the survival of patients with primary gastric-diffuse large B cell lymphoma （PG-DL- BCL） and its influencing factors. Method Clinical data of 184 patients with PG-DLBCL were analyzed retrospectively. The therapeutic regimen, clinical data and follow-up data were recorded and collected. Survival of PG-DLBCL patients was calculated by plotting Kaplan-Meier survival curves; univariate and multivariate Cox analysis were used to analyze factors that may affect the survival of patients with PG-DLBCL. Result At the end of the 5 year follow-up period, 4 pa- tients （2.2%） withdrew and 125 patients （67.9%） survived, the rest 55 patients （29.9%） were all died of PG-DLBCL pro- gression. Kaplan-Meier survival curves showed that the overall survival rates at 1 year, 3 years and 5 years were 88.3%, 71.5% and 67.9%, respectively. Univariate Cox proportional hazards model showed that, Lugano staging, B symptoms, HGB level, ALB level, LDH level, 132 microglobulin level, combined with rituximab, Hp infection had significantly ef- fects on the prognosis of patients （P〈0.05）. However, gender, age, cell origin had no effect on the prognosis of patients （P〉0.05）. The results of multivariate Cox regression showed that the prognosis of patients with PG-DLBCL was not af- fected by symptoms of B, HGB level, ALB level, 132 microglobulin level and Hp infection （P〉0.05）, but Lugano staging, LDH level and rituximab were independent prognostic factors （RR=2.323, 1.792, 0.399, P〈0.05）. Conclusion Lugano stage Ⅲ-IV and elevated LDH level are independent risk factors for the prognosis of patients with PG-DLBCL, combined with rituximab can increase the survival rate of patients.
作者
汪玉芳
柯金勇
柯善栋
WANG Yufang;KE Jinyong;KE Shandong(Department of Hematopathology,Central Hospital of Huangshi,E＇dong Medical Group,Huangshi 435000,Hubei,China)
出处
《癌症进展》
2018年第8期1020-1023,共4页
Oncology Progress
作者简介
通信作者:柯金勇,邮箱:wangyf163yx@163.com
