外周血淋巴细胞绝对数对初诊治原发性中枢神经系统淋巴瘤预后评估的价值  

Prognostic value of the absolute lymphocyte count in patients with newly diagnosed primary central nervous system lymphoma

作　　者：蔡青 魏一鸣 阮航 张明智[1] 李兆明[1] CAI Qing;WEI Yiming;RUAN Hang;ZHANG Mingzhi;LI Zhaoming(Department of Oncology, the First Affiliated Hospital,Zhengzhou University, Zhengzhou 450052)

机构地区：[1]郑州大学第一附属医院肿瘤科,郑州450052

出　　处：《郑州大学学报（医学版）》2021年第4期576-580,共5页Journal of Zhengzhou University(Medical Sciences)

摘　　要：目的:探讨初诊原发性中枢神经系统淋巴瘤(PCNSL)患者外周血淋巴细胞绝对数(ALC)用于预后评估的价值。方法:回顾性分析郑州大学第一附属医院2013年9月至2020年4月初诊的46例PCNSL患者的临床资料。通过时依ROC曲线获得治疗前ALC的截断值,并据此将患者分为低ALC组(n=19)和高ALC组(n=27)。采用Cox比例风险回归模型分析无进展生存期(PFS)和总生存期(OS)的影响因素。结果:PCNSL患者中男23例,女23例,发病年龄27~85岁。通过时依ROC曲线计算出ALC的最佳截断值为1.57×10^(9)个/L。单因素分析显示,ALC、病灶多发、深部病灶对患者的PFS及OS有影响(P<0.05)。多因素分析显示,低ALC是预测患者OS和PFS不良的因素[HR(95%CI):0.140(0.051~0.380),0.178(0.067~0.471),P<0.05]。结论:ALC与PCNSL患者的预后相关,可作为PCNSL患者危险度分层和预后判断的指标。Aim:To investigate the value of the absolute lymphocyte count(ALC)in the prognosis of patients with newly diagnosed primary central nervous system lymphoma(PCNSL).Methods:The clinical data of 46 patients with PCNSL that were admitted in the First Affiliated Hospital of Zhengzhou University between September 2013 and April 2020 were analyzed retrospectively.A time-dependent receiver operator characteristic(ROC)curve was performed to estimate the cut-off value for ALC before the first chemotherapy,and patients were allocated into low ALC group(n=19)and high ALC group(n=27).Cox proportional hazard model was used to analyze the influencing factors of progression free survival(PFS)and overall survival(OS).Results:Among PCNSL patients,23 were male,and the median age range was 27-85 years.According to time-dependent ROC curve,the optimal cut-off value for ALC was 1.57×10^(9)/L.Univariate analysis showed that ALC,multiple brain lesions,and involvement of deep brain regions had impact on patients′PFS and OS(P<0.05).The multivariate analysis showed that ALC was a predictor for OS and PFS[HR(95%CI):0.140(0.051-0.380),0.178(0.067-0.471),P<0.05].Conclusion:ALC is a prognostic factor for PCNSL,and ALC may aid clinicians in risk stratification and prognostic evaluation for PCNSL patients.

关 键 词：原发性中枢神经系统淋巴瘤 预后 淋巴细胞绝对数 

分 类 号：R739.41[医药卫生—肿瘤]