外周T细胞淋巴瘤患者65例预后的相关因素分析  

Prognostic factors of peripheral T cell lymphoma：analysis based on 65 cases

作　　者：何红梅[1] 程晔[1] 孙秀华[1] 张弦[1] 徐丽叶[1] 丁晓蕾[1] 

机构地区：[1]大连医科大学附属第二医院肿瘤4科,大连116027

出　　处：《中华老年多器官疾病杂志》2015年第10期770-774,共5页Chinese Journal of Multiple Organ Diseases in the Elderly

基　　金：大连市科技计划项目（2014E21SF001）

摘　　要：目的：从临床角度分析外周T细胞淋巴瘤（PTCL）的相关因素对预后的影响，为临床病情监测及预后评估提供参考。方法收集2005年1月至2014年12月入住大连医科大学附属第二医院的76例PTCL患者的临床资料，其中65例资料完整，11例病例失访。采用Kaplan-Meier法进行生存分析。对年龄、性别、临床分期、淋巴瘤国际预后指数（IPI）、B症状、血红蛋白（Hb）、血清β2微球蛋白（β2-MG）、乳酸脱氢酶（LDH）、血清白蛋白（ALB）水平，以及治疗方法、病理分型、首发部位、预后指数PIT、骨髓是否受侵等因素进行单因素分析，并进一步采用Cox回归风险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65例PTCL病例中包括非特异型（PTCL-U）25例，结外自然杀伤细胞（NK）/鼻型T细胞淋巴瘤（TCL）10例，血管免疫母细胞性T细胞淋巴瘤（AITL）9例，间变性大细胞淋巴瘤（ALCL）9例。单因素分析表明，年龄≤60岁的患者比＞60岁的患者预后好（P＝0.008）；Ⅰ/Ⅱ期患者比Ⅲ/Ⅳ期患者的5年生存率高（74.4% vs 19.0%，P＝0.011）；IPI指数低危、中低危、中高危、高危组的5年生存率分别为85.7%、52.5%、0.0%和0.0%（P＝0.004）；初诊时LDH升高的患者预后比LDH正常或降低的患者差（P＝0.048）；初诊时ALB降低的患者比ALB正常者预后差（P＝0.008）；首发部位为结外的患者比首发部位在淋巴结的患者预后较好（P＝0.002）。将PIT指数分为0、1、2和≥3组，其5年生存率分别为92.3%、85.7%、17.4%和0.0%（P＝0.002）。多因素分析显示，PIT评分指数为PTCL的独立预后危险因素（P＝0.002）。结论年龄、临床分期、IPI指数、LDH、ALB、病理分型、首发部位及PIT为预后影响因素，PIT为PTCL的独立预后影响因素。Objective To determine the effects of relative factors of peripheral T cell lymphoma （PTCL） on the prognosis based on clinical data in order to provide references for monitoring clinical condition and predicting prognosis of the disease. Methods Clinical data of 76 PTCL patients were enrolled firstly, but 11 patients were lost to follow-up. So a total of 65 cases with complete medical records admitted in our department from January 2005 to December 2014 were finally enrolled and retrospectively analyzed. Kaplan-Meier analysis was used. Univariate analysis was employed to analyze age, gender, clinical stage, international prognostic index （IPI）, B symptoms, hemoglobin （Hb）, serum β2 microglobulin （β2-MG）, lactate dehydrogenase （LDH）, serum albumin （ALB）. treatment protocol, pathological classification, primary site, prognostic index （PIT） for PTCL-unspecified （PTCL-U）, and bone marrow infiltration. And then, Cox regression model was carried out to perform multivariate analysis on those statistically significant parameters from univariate analysis. Results Among the cohort of 65 patients, 25 of them suffered from PTCL-U, 10 from extranodal natural killer cell （NK）/T lymphocytes-nasal type, 9 from angioimmunoblastic T-cell lymphoma （AITL）, and 9 from anaplastic large cell lymphoma （ALCL）. Univariate analysis showed that patients older than 60 years had a poor prognosis than those younger （P=0.008）. The 5-year survival rate was significantly higher in the patients at Ann Arbor stage Ⅰ/Ⅱ than those at Ⅲ/Ⅳ（74.4% vs 19.0%, P=0.011）. The 5-year survival rate was 85.7%, 52.5%, 0.0% and 0.0%, respectively for the patients with IPI score as low, low-medium, high-medium, and high risk （P=0.004）. The patients with elevated LDH at diagnosis had poorer prognosis than those with normal or reduced values （P=0.048）, so did the patients with lower ALB than those with normal ALB （P=0.008）. The patients with extranodal lymphoma as primary site had better progno

关 键 词：外周T细胞淋巴瘤 预后 

分 类 号：R733.4[医药卫生—肿瘤]