初次诊断Ⅲ级或伴转化滤泡性淋巴瘤患者预后影响因素分析  

Prognostic factors of patients with primary diagnosis of gradeⅢor transformational follicular lymphoma

作　　者：刘威[1] 王敬君[1] 邹万强 李小翠[1] LIU Wei;WANG Jingjun;ZOU Wanqiang;LI Xiaocui(Department of Rheumatology and Immunology,Central Hospital of Tieling City,Liaoning Tieling 112000,China)

机构地区：[1]铁岭市中心医院血液风湿免疫科,辽宁铁岭112000

出　　处：《现代肿瘤医学》2022年第8期1468-1472,共5页Journal of Modern Oncology

摘　　要：目的:探讨初次诊断Ⅲ级或伴转化滤泡性淋巴瘤(follicular lymphoma,FL)患者预后影响因素。方法:回顾性分析我院2011年1月至2018年6月收治初次诊断Ⅲ级或伴转化FL患者共94例临床资料,根据基线临床资料进行随访生存资料亚组分析,采用单因素和多因素法确定预后独立影响因素。结果:全部患者随访3年累积无进展生存(PFS)率和累积总生存(OS)率分别为56.15%,81.79%。不同IPI评分、FLIPI-1评分、FLIPI-2评分、Ann Arbor分期、淋巴结受累部位、直径3 cm以上淋巴结受累部位及结外病变亚组患者随访3年累积PFS率比较差异有统计学意义(P<0.05);不同IPI评分、FLIPI-1评分、FLIPI-2评分及LDH水平亚组患者随访3年累积OS率比较差异有统计学意义(P<0.05)。单因素分析结果显示,Ann Arbor分期Ⅲ-Ⅳ期、淋巴结受累部位≥5个、直径>3 cm受累淋巴结个数≥3、结外受累部位≥2个、IPI评分2~3分、FLIPI-1评分/FLIPI-2评分≥3分均与初次诊断Ⅲ级或伴转化FL患者PFS有关(P<0.05);IPI评分2~3分、FLIPI-2评分≥3分及LDH≥240 IU/mL均与初次诊断Ⅲ级或伴转化FL患者OS有关(P<0.05)。多因素分析结果显示,IPI评分2~3分是初次诊断Ⅲ级或伴转化FL患者PFS独立影响因素(P<0.05);IPI评分2~3分和FLIPI-1评分≥3分均是初次诊断Ⅲ级或伴转化FL患者OS独立影响因素(P<0.05)。结论:初次诊断Ⅲ级或伴转化FL患者生存获益与IPI评分和FLIPI-2评分独立相关。Objective:To investigate the prognostic influencing factor of primary FL patients with gradeⅢor transformation.Methods:Clinical data of 94 primary FL patients with gradeⅢor transformation were retrospectively chosen in the period from January 2011 to June 2018.According to the baseline clinical data,the survival data were analyzed by subgroup and the single factor and multi factor methods were used to determine independent prognostic factors.Results:The cumulative PFS rate and cumulative OS rate with 3-year follow-up of all patiens were separately 56.15%,81.79%.There were significant differences in cumulative progression-free survival rate and cumulative overall survival rate among different subgroups of IPI,FLIPI-1 and FLIPI-2 in 3-year follow-up(P<0.05).There were significant differences in cumulative progression-free survival rate among different subgroups of Ann Arbor staging,lymph node involvement site,lymph node involvement site for diameter≥3 cm and extranodal lesions in 3-year follow-up(P<0.05).There were significant differences in cumulative overall survival rate among different subgroups of LDH levels in 3-year follow-up(P<0.05).Univariate analysis showed that Ann Arbor stage forⅢ-Ⅳ,lymph node involvement site number≥5,>3 cm lymph node involvement site number≥3,extranodal lesion site number≥2,IPI score for 2~3 points,FLIPI-1 score and FLIPI-2 score≥3 were the risk factors for PFS(P<0.05).LDH≥240 IU/mL,IPI score for 2~3 points and FLIPI-2 score≥3 were the risk factors for overall survival(P<0.05).Multivariate analysis showed that IPI score for 2~3 points was the independent risk factor for PFS(P<0.05).IPI score for 2~3 point and FLIPI-1 score≥3 were the independent risk factor for OS(P<0.05).Conclusion:Survival benefit of primary FL patients with gradeⅢor transformation are independently associated with IPI score and FLIPI-2 score.

关 键 词：滤泡性淋巴瘤 病理组织学分级 无进展生存时间 总生存时间 影响因素 

分 类 号：R733[医药卫生—肿瘤]