国际预后指数修订国际预后指数改良国际预后指数及西班牙淋巴瘤组/自体骨髓移植国际预后指数对弥漫性大B细胞淋巴瘤的预后评估价值  

Prognostic value of international prognostic index,revised international prognostic index,enhanced international prognostic index and Grupo Espanol de Linfomas/trasplante autologo de medula oseainternational prognostic index for diffuse large B-cell lymphoma

作　　者：冯要须 苏丽萍[2] Feng Yaoxu;Su Liping(Graduate School of Shanxi Medical Universityy Taiyuan 030000,China;Department of Hematology,Cancer Hospital Affiliated to Shanxi Medical University,Taiyuan 030000,China)

机构地区：[1]山西医科大学研究生院,太原030000 [2]山西医科大学附属肿瘤医院血液科,太原030000

出　　处：《中华肿瘤杂志》2020年第11期949-954,共6页Chinese Journal of Oncology

摘　　要：目的比较国际预后指数(IPI)、修订国际预后指数(R-IPI)、改良国际预后指数(NCCN-IPI)及西班牙淋巴瘤组/自体骨髓移植国际预后指数(GELTAMO-IPI)等预后分层模型对弥漫性大B细胞淋巴瘤(DLBCL)的预后评估价值。方法回顾性收集2011年9月至2016年3月山西省肿瘤医院收治的238例初治DLBCL患者的临床资料,按IPI、R-IPI、NCCN-IPI及GELTAMO-IPI对患者进行危险分层和预后评估。采用Kaplan-Meier法进行生存分析,采用Cox回归分析比较各危险组患者发生进展和死亡的风险,采用Harrell′s C-incex法比较各危险分层模型的预测精确度。结果 IPI低危组、中低危组、中高危组和高危组患者的3年无进展生存率分别为90.9%、67.5%、54.0%和52.4%,3年总生存率分别为93.9%、72.5%、58.0%和53.7%。预后很好组、预后好组和预后差组患者的3年无进展生存率分别为90.9%、79.8%和53.0%,3年总生存率分别为95.5%、83.3%和55.3%。NCCN-IPI低危组、中低危组、中高危组和高危组患者的3年无进展生存率分别为91.7%、76.5%、66.7%和41.1%,3年总生存率分别为95.8%、79.4%、70.0%和42.9%。GELTAMO-IPI低危组、中低危组、中高危组和高危组患者的3年无进展生存率分别为91.3%、76.3%、67.4%和32.7%,3年总生存率分别为95.7%、80.7%、67.4%和34.5%。Cox回归分析显示,IPI中低危组与低危组间患者的进展风险和死亡风险差异明显(HR分别为4.144和5.085),R-IPI预后差组与预后好组患者的进展风险和死亡风险差异明显(HR分别为2.752和3.171),但明显弱于IPI。NCCN-IPI和GELTAMO-IPI危险分层中,均显示高危组与中高危组患者的进展风险和死亡风险差异明显,但GELTAMO-IPI对于高危患者的甄别能力优于NCCN-IPI(NCCN-IPI危险分层的HR分别为2.290和2.309,GELTAMO-IPI危险分层的HR分别为3.084和2.966)。Harrell′s C-incex法分析显示,IPI、R-IPI、NCCN-IPI和GELTAM0-IPI预测DLBCL患者3年无进展生存的C-index分别为0.672、0.Objective To compare the prognostic values of international prognostic index(IPI),revised international prognostic index(H-IPI),enhanced international prognostic index(NCCN-IPI)and Grupo Espanol de Linfomas/trasplante autologo de medula 6sea-intemational prognostic index(GELTAMO1PI)for diffuse large B-cell lymphoma(DLBCL).Methods The clinical data of 238 DLBCL patients who were initially treated in Shanxi Cancer Hospital from September 2011 to March 2016 were collected retrospectively,the risk stratification and prognostic evaluation were conducted according to the IPI,R-IPI,NCCN-IPI and GELTAMO-IPI.Survival analysis was performed by the Kaplan-Meier method,COX regression analysis was used to compare the risks of death and progress in each group.Harrell's Cstatistics was used to compare the prediction accuracy of each hazard stratification model.Results The 3-years progression-free survival rates of low risk,middle-low risk,middle-high risk and high risk group stratified according to IPI were 90.9%,67.5%,54.0%and 52.4%,respectively.The 3-vears overall survival rates of each group were 93.9%,72.5%,58.0%and 53.7%,respectively.The 3-years progression-free survival rates of patients with very good prognosis,good prognosis and poor prognosis were 90.9%,79.8%and 53.0%,respectively,the 3-years overall survival rates were 95.5%,83.3%and 55.3%,respectively.The 3-years of progression-free survival of low risk group,middle-low risk group,middle-high risk group and high risk group stratified according to NCCN-IPI were 91.7%,76.5%,66.7%and 41.1%,respectively.The 3-years overall survival rates of each group were 95.8%,79.4%,70.0%and 42.9%,respectively.The 3-vears progression-free survival rates of low risk,middle-low risk,middle-high risk and high risk group stratified according to GELTAMO-IPI were 91.3%,76.3%,67.4%and 32.7%,respec tively.The 3-years overall sunival rates of each group were 95.7%,80.7%,67.4%and 34.5%,respectively.Cox regression analysis showed that the risks of progression and death were significantly differen

关 键 词：弥漫性大B细胞淋巴瘤 国际预后指数 预后 

分 类 号：R733.1[医药卫生—肿瘤]