外周血细胞计数在PGI-DLBCL患者预后评估中的价值  

Value of peripheral blood cell count in prognosis evaluation of patients with PGI-DLBCL

作　　者：赵盼[1] 于泳[1] 王亚非[1] 赵智刚[1] 张翼鷟[1] 王晓芳[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.天津市恶性肿瘤临床医学研究中心,天津300060

出　　处：《山东医药》2016年第45期1-5,共5页Shandong Medical Journal

基　　金：国家自然科学基金资助项目(81272562)

摘　　要：目的探讨外周血细胞计数在原发胃肠道弥漫大B细胞淋巴瘤（PGI-DLBCL）患者预后评估中的价值。方法回顾性分析2009年3月-2015年5月经病理检查明确诊断为PGI-DLBCL患者的临床资料,分析其绝对淋巴细胞计数（ALC）、绝对单核细胞计数（AMC）、淋巴细胞计数与单核细胞计数比值（LMR）及PLT计数与淋巴细胞计数比值（PLR）对PGI-DLBCL患者5年总生存率、5年无疾病进展生存率的影响。将168例患者根据国际预后指数（IPI及aa IPI）评分分为低危、低中危、中高危、高危组,根据LMR联合IPI或aa IPI评分分为3组,其中LMR≥2.5、低危患者为预后良好组,LMR〈2.5、高危患者为预后极差组,其余为预后一般组。比较各组的总生存率、无疾病进展生存率。结果患者中位年龄55岁（12-90岁）,中位随访时间25个月（8-79个月）。单因素分析提示,ALC、AMC、LMR、PLR与5年总生存率、5年无疾病进展生存率有关（P均〈0.05）。多因素分析提示,5年无疾病进展生存率与ALC、LMR、乳酸脱氢酶有关（P均〈0.05）,5年总生存率与年龄、LMR有关（P均〈0.05）。低危、低中危、中高危、高危组中,中高危与高危组5年总生存率和无疾病进展生存率差异无统计学意义（5年总生存率分别为32.0%、23.8%;5年无疾病进展生存率分别为20.0%、23.8%;P均〉0.05）。预后良好组、预后一般组、预后极差组5年总生存率分别为82.8%、60.0%、14.3%,5年无疾病进展生存率分别为79.3%、53.8%、14.8%。3组及组间两两比较,P均〈0.05。结论初诊时外周血细胞计数对评估PGI-DLBCL患者的预后有重要价值。LMR联合IPI评分有助于PGI-DLBCL患者发病初期更好地进行危险分层。Objective To investigate the value of peripheral blood cell count in the prognosis evaluation of patients with primary gastrointestinal diffuse large B-cell lymphoma（ PGI-DLBCL）. Methods We retrospectively analyzed the clinical data from patients with newly diagnosed diffuse large B-cell lymphoma who were confirmed by pathology from March2009 to May 2015. We analyzed the effects of the absolute lymphocyte count（ ALC）,absolute monocyte count（ AMC）,absolute lymphocyte count/absolute monocyte count ratio（ LMR） and platelet count/absolute lymphocyte count ratio（ PLR） on the 5-year overall survival（ OS） and progression-free survival（ PFS）. One hundred and sixty-eight patients were divided into low risk,intermediate risk,intermediate to high risk and high risk groups according to international prognostic index（ IPI） and aa IPI scores. According to the LMR combined with IPI or aa IPI we divided into three groups：（ 1）good prognosis group： LMR ≥2. 5 and low risk patients,（ 2） poor prognosis group： LMR 2. 5 and high risk patients,（ 3） general prognosis group： the rest of cases except the above. The OS and PFS was compared between these groups. Results The mean age of all patients was 55（ 12-90） years old,and the median follow-up was 25（ 8-79） months. Univariate analysis showed that ALC,AMC,LMR and PLR were associated with the 5-year OS and PFS（ all P〈0. 05）. Multivariate analysis showed that 5-year PFS was related with ALC,LMR and LDH,and 5-year OS was related with age and LMR（ all P〈0. 05）. There were no significant difference in 5-year OS and 5-year PFS between intermediate to high risk group and high risk group（ 5-year OS was 32%,23. 8%,and 5-year PFS was 20. 0%,23. 8%）. There were statistically significant differences in 5-year OS and 5-year PFS among good prognosis group,general prognosis group and poor prognosis group（ 5-year OS was 82. 8%,60. 0% and 14. 3%; 5-year PFS was 79. 3%,53. 8% and 14. 8%,respectively）. Conclusion At the first

关 键 词：原发胃肠道弥漫大B细胞淋巴瘤 绝对淋巴细胞计数 绝对单核细胞计数 血小板计数 预后 

分 类 号：R733.4[医药卫生—肿瘤]