套细胞淋巴瘤血清β2-微球蛋白水平与临床特征及预后的相关性分析  

Correlation of serum β2-microglobulin expression with the clinical characteristics and prognosis of mantle-cell lymphoma

作　　者：贾晓辉[1] 孔令喆 王先火[1] 张会来[1] 

机构地区：[1]天津医科大学肿瘤医院淋巴瘤科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院研究中心,天津300060

出　　处：《肿瘤》2017年第6期642-649,共8页Tumor

基　　金：国家自然科学基金资助项目(编号:8140295)~~

摘　　要：目的:探讨血清β2-微球蛋白(β2-microglobulin,β2-MG)对套细胞淋巴瘤(mantle-cell lymphoma,MCL)患者生存预后的影响,以及与MCL国际预后指数(MCL international prognostic index,MIPI)之间的关系。方法:回顾分析了61例MCL患者的临床资料,分析其异常的血清β2-MG表达是否影响患者预后。血清β2-MG表达水平与患者临床特征之间相关性分析采用Fisher精确检验法,预后的多因素分析采用COX比例风险回归模型。结果:MCL患者初次确诊的生化指标检查结果显示,61例患者中35例(57.4%)患者有血清β2-MG异常升高,并且与临床分期(P=0.011)、B症状(P=0.032)、骨髓受累(P<0.001)、乳酸脱氢酶(P=0.001)、白细胞计数(P=0.008)、Ki-67(P=0.010)及MIPI评分(P=0.005)显著相关。多因素分析显示,血清β2-MG是影响MCL患者预后的独立危险因素(P=0.022),并且在MIPI的中危组(4~5分)中,血清β2-MG异常升高的患者的总生存期显著短于血清β2-MG正常患者(P<0.001),而在低危组(0~3分)和高危组(6~11分)中差异无统计学意义。结论:血清β2-MG是影响MCL患者预后的独立危险因素,特别在MIPI评分中危组中血清β2-MG>2.5 mg/L患者的总生存期明显短于血清β2-MG≤2.5 mg/L者。Objective： To investigate the correlation of serum β2-microglobulin （β2-MG） with overall survival and mantle-cell lymphoma international prognostic index （MIPI） of patients with mantle-cell lymphoma （MCL）.Methods： The clinical data of 61 MCL patients admitted in Tianjin Medical University Cancer Institute and Hospital were retrospectively analyzed. Fisher＇s exact test was used to analyze the relationship between serum β2-MG level and the clinical features of MCL patients. COX proportional hazards model was used to analyze the influencing factors of prognosis in MCL patients.Results： In total of 61 MCL patients, 35 （57.4%） had abnormal elevation of serum β2-MG. The level of serum β2-MG was significantly associated with clinical stage （P= 0.011）, B symptom （P= 0.032）, bone marrow （P 〈 0.001）, lactate dehydrogenase （P= 0.001）, white blood cell count （P= 0.008）, Ki-67 （P= 0.010） and MIPI score （P= 0.005）. Multivariate analysis showed that serum β2-MG was an independent risk factor for the prognosis of MCL patients （P= 0.022）. The overall survival of patients with elevated serum β2-MG was shorter than that of the patients with normal serum β2-MG in intermediate risk group （4-5 points） according to MIPI score （P 〈 0.001）, but there was no significant difference in low risk group （0-3 points） and high risk group （6-11 points）.Conclusion： Serum β2-MG is an independent risk factor for the prognosis of MCL patients. Especially in the intermediate risk group according to MIPI score, the MCL patients with serum β2-MG 〉 2.5 mg/L have a poor overall survival as compared with the pateints with serum β2-MG ≤2.5 mg/L.

关 键 词：套细胞淋巴瘤 Β2-微球蛋白 MIPI 预后 

分 类 号：R733.4[医药卫生—肿瘤]