外周血淋巴细胞绝对数对弥漫大B细胞淋巴瘤患者预后价值的临床分析  

Prognostic significance of absolute lymphocyte count in the diagnosis of diffuse large B-cell lymphoma

作　　者：马芹[1] 张会来[1] 王华庆[1] 陈青青[1] 刘霞[1] 侯芸[1] 

机构地区：[1]天津医科大学肿瘤医院淋巴瘤科、天津市肿瘤防治重点实验室、国家肿瘤临床医学研究中心、中美淋巴血液肿瘤诊治中心,天津市300060

出　　处：《中国肿瘤临床》2014年第8期503-507,共5页Chinese Journal of Clinical Oncology

基　　金：天津市“抗癌重大专项攻关计划”项目(编号:12ZCDZSY17800)资助

摘　　要：目的:探讨弥漫大B细胞淋巴瘤患者在首次诊断时外周血淋巴细胞绝对数(absolute lymphocyte count,ALC)与其临床特征及预后之间的关系。方法:回顾性的分析天津医科大学肿瘤医院2002年2月至2008年4月收治143例初治弥漫大B细胞淋巴瘤患者的临床特征及预后,分析不同ALC水平与患者各临床特征之间的关系。结果:将143例弥漫大B细胞淋巴瘤患者分为高ALC(ALC≥1.0×109/L)组和低ALC(ALC<1.0×109/L)组,低ALC组患者常伴随B症状、高IPI评分、Ann Arbor分期较晚以及乳酸脱氢酶水平、β2-微球蛋白水平升高(P<0.05)。而且高ALC组患者的缓解率比低ALC组高(P=0.003)。多因素分析显示Ann ArborⅢ/Ⅳ期、ALC<1.0×109/L是弥漫大B细胞淋巴瘤患者预后较差的独立因素。ALC降低组常伴有Ann Arbor分期的升高。结论:ALC是弥漫大B细胞淋巴瘤患者新的独立预后因素。Objective： We investigated the clinical significance and prognostic value of peripheral blood absolute lymphocyte count （ALC） in the diagnosis of diffuse large B-cell lymphoma. Methods：The medical records of 143 patients with diffuse large B-cell lymphoma were reviewed. These patients were diagnosed and underwent surgery in Tianjin Medical University Cancer Institute and Hospital, China, between February 2002 and April 2008. The correlation between different ALC levels and clinical features was statisti-cally analyzed. Results：Patients with low ALC （〈1.0×109/L） at diagnosis showed B symptoms, an international prognostic index score of ≥2, advanced clinical stage （Ann Arbor III/IV）, high lactate dehydrogenase level, and high β2-microglobulin level （P〈0.05）. Pa-tients with high ALC （≥1.0 × 109/L） responded well to treatment （P=0.003）. In multivariate analysis, Ann Arbor stage and ALC level were independent prognostic factors of patients with diffuse large B-cell lymphoma. Patients with low ALC often exhibited advanced clinical stage （Ann ArborⅢ/Ⅳ）. Conclusions：ALC level obtained at diagnosis is a novel, powerful prognostic factor of diffuse large B-cell lymphoma.

关 键 词：淋巴细胞绝对数 弥漫大B细胞淋巴瘤 预后 非霍奇金淋巴瘤 

分 类 号：R733.1[医药卫生—肿瘤]