原发性胃肠道恶性淋巴瘤术后生存期的影响因素及TNM分期对远期生存的预测价值分析  

Prognostic factors of postoperative survival in patients with primary gastrointestinal malignant lymphoma and the predictive value of TNM staging for long-term survival

作　　者：刘玉[1] 王子安 LIU Yu;WANG Zian(Bengbu Medical College of Anhui Province,Bengbu 233030,China;Department of Oncology,First Affiliated Hospital of Bengbu Medical College)

机构地区：[1]安徽省蚌埠医学院,蚌埠233030 [2]安徽省蚌埠医学院第一附属医院肿瘤内科

出　　处：《实用肿瘤学杂志》2018年第4期315-319,共5页Practical Oncology Journal

摘　　要：目的探讨原发性胃肠道恶性淋巴瘤术后生存期的影响因素及TNM分期对远期生存的预测价值。方法纳入我院收治的原发性胃肠道恶性淋巴瘤患者102例,对患者临床资料进行回顾性分析。通过电话随访明确其术后5年内的生存情况与生存时间,采用Cox回归分析观察原发性胃肠道恶性淋巴瘤患者生存期的影响因素,利用Kaplan-Meier绘制生存曲线图分析TNM分期对患者生存期的预测价值。结果在102例患者中,死亡41例,占全部病例的40.20%;生存组无远处转移、TNM分期Ⅰ~Ⅱ期、Lugano分期Ⅰ~Ⅱ期占比高于死亡组,差异有统计学意义(P<0.05);以TNM进行分期时,患者Ⅰ期、Ⅱ期、Ⅲ期、Ⅳ期5年内的生存率分别为54.10%、21.31%、16.39%、8.20%。以Lugano进行分期时,患者Ⅰ期、Ⅱ期、ⅡE期、Ⅳ期5年内的生存率分别为52.46%、22.95%、13.11%、11.48%,经Cox回归分析提示远处转移、TNM分期、Lugano分期与患者生存期有关(P<0.05);TNM分期对患者远期生存率的预测优于Lugano分期。结论胃恶性淋巴瘤患者远期生存期的影响因素包括远处转移、TNM分期以及Lugano分期,与Lugano分期比较,TNM分期对远期生存期的预测效果更理想。Objective The aim of this study was to explore the prognostic factors of postoperative survival of patients with primary gastrointestinal malignant lymphoma and the predictive value of TNM staging for long-term survival. Methods A total of102 patients with primary gastrointestinal malignant lymphoma admitted into our hospital were retrospectively analyzed. The survival and survival time of 5 years after operation were confirmed by telephone follow-up. Cox regression analysis was used to observe the survival factors of patients with primary gastrointestinal malignant lymphoma. The survival curve of Kaplan Meier was used to analyze the predictive value of TNM staging on survival time of patient. Results Among the 102 patients,61 survived and 41 died,accounting for 59. 80% and 40. 20%,respectively. There was no distant metastasis and TNM stage in the survival group. The proportion of stage I to stage II and Lugano was higher than that in the death group. The difference was statistically significant（ P 0. 05）. The Cox regression analysis showed that the distant metastasis,TNM stage and Lugano staging were positively related to patient death（ P 0.05）. Using TNM staging in patients with stage Ⅰ,Ⅱ,Ⅲ and Ⅳ of 5 years survival rates were 54. 10%,21. 31%,16. 39%,21.31%. Using of Lugano staging in patients with stage Ⅰ,Ⅱ,Ⅱ E and Ⅳ of 5 years survival rate were 52. 46%,22. 95%,13. 11%,11. 48%. The prediction of long-term survival rate by TN. Conclusion The factors affecting the long-term survival of patients with gastric malignant lymphoma include distant metastasis,TNM staging,and Lugano staging. Compared with Lugano staging,the predictive effect of TNM staging on the long term survival is more ideal.

关 键 词：胃肠道恶性淋巴瘤 TNM分期 生存曲线 影响因素 

分 类 号：R735.2[医药卫生—肿瘤]