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作 者:林晓骥[1] 何牧卿[1] 郭文坚[1] 潘夏惠[1] 朱宝玲[1] 姚荣欣[1]
出 处:《医学研究杂志》2013年第5期149-152,共4页Journal of Medical Research
摘 要:目的探讨和比较原发结内与原发结外弥漫性大B细胞淋巴瘤临床特征和预后。方法回顾性分析2001~2012年间的132例原发结内外DCBCL患者的临床特征及治疗疗效,并对生存情况和预后等相关因素进行统计学分析。结果与原发结内患者相比,原发结外患者多表现为Ann Arbor分期早以及LDH升高、β2-微球蛋白升高、全身症状的比例较低;原发结内、外DLBCL患者的总有效率分别为:77%和81%(P>0.05);原发结内、外DLBCL患者5年PFS分别为:48.6%和63.7%,(P<0.05)。原发胃肠道与非原发胃肠道的结外DLBCL患者5年OS和5年PFS分别为80.0%、50.0%(P<0.05)和76%、48.5%(P<0.05);单因素分析显示年龄、乳酸脱氢酶升高、ECOG评分、IPI评分、是否胃肠道侵犯以及GCB型是全组DLBCL患者的独立预后因素;多因素分析只有显示年龄、IPI评分、ECOG评分及GCB型与患者预后差有关。结论与原发结内患者相比,原发结外患者具有某些不同临床特征,原发结外尤其原发胃肠道患者可能具有更好的生存情况。Objective To assess and compare the clinical characteristics and prognosis of patients between diffuse large B -cell lymphoma(DLBCL) of nodal and extranodal primary origin. Methods Totally 132 cases with DLBCL were admitted to hospital between 2001 and 2012. the clinical feature and efficacy of DLBCL were retrospectively studied. The factors that related to survival and prognosis were statistically analysed. Results Comparing with nodal DLBCL(N - DLBCL), patients with extranodal DLBCL(EN - DLBCL) pres- ented with lower Ann Arbor stage, less B - symptoms, lower lactate dehydrogenase(LDH) and 152 - microglobulin( 132 - MG) level. The total effective rate for N - DLBCL and EN - DLBCL was 77% and 81% ( P 〉 O. 05 ) , respectively. The 5 - year progression - free survival (PFS) of patients for N - DLBCL and EN - DLBCL was 48.6% and 63.7 % ( P 〈 0.05 ), respectively. The 5 - year overall survival(OS) and the 5 - year PFS for primary gastrointestinal DLBCL( GI - DLBCL) and non - GI DLBCL was 80.0% ,50.0% (P 〈0.05) and 76% , 48.5% (P 〈0.05). By univariate analysis, age, elevated LDH, ECOG performance score, IPI, gastric involvement and GCB subtypes were prognostic predictors for all DLBCL patients. By multivariate analysis, age, ECOG performance score, IPI and GCB subtypes were prognostic predictors for all patients. Conclusion Comparing with N - DLBCL, EN - DLBCL represents distinct clinical features and better prognosis especially for GI - DLBCL.
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