27例套细胞淋巴瘤的临床特征及预后分析  

Analysis of clinical features and prognosis of 27 patients with mantle cell lymphoma

作　　者：张曼[1] 赵阔[1] 杨芳[1] 张会来[1] 邱立华[1] 周世勇[1] 钱正子[1] 李兰芳[1] 

机构地区：[1]天津医科大学肿瘤医院、国家肿瘤临床医学研究中心、天津市“肿瘤防治”重点实验室,综合内一科,300060

出　　处：《天津医药》2016年第9期1128-1131,共4页Tianjin Medical Journal

摘　　要：目的：探讨套细胞淋巴瘤（MCL）的临床特征、化疗方案的疗效及预后情况。方法回顾性分析27例MCL患者资料，分析其临床特征及治疗方案，采用Cox回归分析MCL预后的影响因素。结果27例患者中位发病年龄为68岁，男女比例为4.4∶1，Ann Arbor分期Ⅲ～Ⅳ者25例（92.6%），肝脾肿大者8例（29.6%），淋巴结外受累部位＞2者7例（25.9%）、ECOG评分2～4分者4例（14.8%），MIPI评分0～3分者8例（29.6%）、4～5分者14例（51.9%）、6～11分者5例（18.5%），Ki-67≤30%者9例（33.3%），＞30%者18例（67.7%），有B症状者10例（37.0%），乳酸脱氢酶（LDH）值升高者17例（63.0%），β2-微球蛋白值升高者8例（29.6%），骨髓浸润者7例（25.9%）。R-CHOP方案组总有效率（ORR）为81.8%，CHOP方案组ORR为68.8%。多因素分析示年龄、LDH、Ki-67为影响MCL预后的独立因素（P＜0.05）。结论 MCL以晚期多见，年龄＞60岁、LDH值升高、Ki-67＞30%的患者预后不佳。Objective To study the clinical features, effects of therapeutic regimen and prognosis of patents withmantle cell lymphoma （MCL）. Methods Clinical data of 27 MCL patients admitted in Tianjin Medical University CancerInstitute ＆ Hospital from January 2008 to December 2014 were retrospectively analyzed. Cox regression analysis was used toanalyze influencing factors of prognosis of MCL. Results The median age was 68 years old for 27 patients, and the male-tofemaleratio was 4.4∶1. Ann Arbor staging showed that 25 cases were stage Ⅲ-Ⅳ（92.6%）, 8 cases were heptosplenomegaly（29.6%）, 7 cases showed extranodal involvement （25.9%）. ECOG scoring showed that 4 cases with scores of 2-4 （14.8%）, 8cases were 0-3 （29.6%）, 14 cases were 4-5 （51.9%） and 5 cases were 6-11 （18.5%）. The Ki-67 index ≤30% was found in 9cases （33.3%）, and〉30% was found in 18 cases （67.7%）. Patients with B symptom was found in 10 （37.0%）. The elevatedlactate dehydrogenase （LDH） was found in 17 cases （63.0%）. The increased Beta 2- microglobulin was found in 8 cases（29.6%）. Seven patients were found with bone marrow involvement. The total effective rate （ORR） was 81.8% in group withR-CHOP method, and the ORR was 68.8% in group with CHOP method. Multivariate analysis showed that age, LDH andKi-67 were independent factors influencing the prognosis of MCL （P〈0.05）. Conclusion Most patients with MCL arefound in advanced stage. Patients with age〉60 years, elevated LDH and Ki-67 index〉30% are with poor prognosis.

关 键 词：淋巴瘤 膜细胞 L-乳酸脱氢酶 KI-67抗原 淋巴瘤 预后 套细胞淋巴瘤 MIPI评分 

分 类 号：R733.4[医药卫生—肿瘤]