弥漫大B细胞淋巴瘤194例临床分析  

A Clinical Analysis of 194 Cases of Diffuse Large B-cell Lymphoma

作　　者：敬小梅[1] 吴萍[1] 李力[1] 熊竹娟[1] 任苑蓉[1] 魏雯[1] 张智慧[1] 

机构地区：[1]四川省肿瘤医院肿瘤内科,成都610041

出　　处：《肿瘤预防与治疗》2015年第6期342-346,共5页Journal of Cancer Control And Treatment

摘　　要：目的：分析弥漫大B细胞淋巴瘤（DLBCL）的临床特征和治疗方法,探讨DLBCL的疗效及预后影响因素。方法：对我院2009~2014年收治的194例DLBCL的临床资料进行回顾性分析,以确定相关因素与疗效及预后的关系。治疗方法包括单纯化疗及化放疗,化疗方案为CHOP及R-CHOP方案。结果：194例患者中位年龄53岁,男女比1.66：1。194例患者中未治疗10例,184例接受治疗的患者中68例（37.0%）获得完全缓解（CR）,72例（39.1%）获得部分缓解（PR）,有效率为76.1%。单因素分析显示患者合并症、结外侵犯、血清LDH水平、B症状、大病灶、血红蛋白水平、临床分期、细胞来源对疗效有显著影响,患者结外侵犯、大病灶、临床分期对生存率有影响,差异有统计学意义。Objective： To analyze the clinical chracteristics,therapeutic approach of diffuse large B-cell lymphoma（ DLBCL）,and to explore the influence factors on the therapeutic effect and prognosis of DLBCL. Methods： A total of 194 DLBCL patients treated in Sichuan Cancer Hospital from 2009 to 2014 were selected,the general clinical characteristics were analyzed to determine the relationship of relevant factors with therapeutic effect and prognosis. The patients were treated with chemotherapy or chemoradiotherapy. The chemotherapy regimens included CHOP and R-CHOP. Results： The median age of the 194 patients was 53 years. The ratio of male： female was 1. 66： 1. Among 184 patients who accepted treatment,68 cases（ 37. 0%） got complete remission（ CR） and 72 cases（ 39. 1%） got partial remission（ PR） after treatment with an effective rate of 76. 1% in all. Univariate analysis showed that the complications of patients、extranodal involvement、the serum level of LDH、B symptom、bulky disease、the level of hemoglobin、the clinical stage and cell origins were important influence factors for curative effect. The extranodal involvement、bulky disease and the clinical stage had significant influence on the survival rate of patients（ P 0. 05）. In Cox multivariable analysis,the clinical factors including clinical stage and bulky disease were independent predicting factors for overall survival（ OS）（ P 0. 05）. R-CHOP can extend the OS of patients remarkably（ P 0. 05）. Conclusion： DLBCL commonly occurs in male patients at middle ages. The clinical stage and bulky disease are independent factors for the OS of DLBCL. R-CHOP may be the best effective approach for treatment of this disease.

关 键 词：淋巴瘤 弥漫大B细胞 临床 预后 

分 类 号：R733.1[医药卫生—肿瘤]