治疗前清蛋白在结外鼻型NK/T细胞淋巴瘤预后评估中的价值  

Value of pretreatment albumin in prognostic assessment of extranodal nasal type NK/T cell lymphoma

作　　者：梁玉[1] 李红卫[1] 侯庆[2] 曹欣 姚宁宁 孙博辰 曹建忠[1] Liang Yu;Li Hongwei;Hou Qing;Cao Xin;Yao Ningning;Sun Bochen;Cao Jianzhong(Department of Radiotherapy,Shanxi Province Cancer Hospital,Shanxi Hospital Affiliated to Cancer Hospital,Chinese Academy of Medical Sciences,Cancer Hospital Affiliated to Shanxi Medical University,Taiyuan 030013,China;Department of Radiobiology,Shanxi Province Cancer Hospital,Shanxi Hospital Affiliated to Cancer Hospital,Chinese Academy of Medical Sciences,Cancer Hospital Affiliated to Shanxi Medical University,Taiyuan 030013,China)

机构地区：[1]山西省肿瘤医院,中国医学科学院肿瘤医院山西医院,山西医科大学附属肿瘤医院放疗科,太原030013 [2]山西省肿瘤医院,中国医学科学院肿瘤医院山西医院,山西医科大学附属肿瘤医院放射生物室,太原030013

出　　处：《肿瘤研究与临床》2022年第4期281-286,共6页Cancer Research and Clinic

基　　金：山西省重点研发计划(201803D31174);山西省留学回国人员科技活动择优资助项目(晋人社厅[2019]1176号)。

摘　　要：目的探讨治疗前清蛋白在结外鼻型NK/T细胞淋巴瘤(ENKTL)预后中的价值。方法回顾性分析2002年1月至2018年12月山西省肿瘤医院收治的184例ENKTL患者的临床资料。采用Contal-O’’Quigley变点法计算清蛋白预测患者预后的最佳临界值;采用倾向评分匹配(PSM)减少选择偏差;采用Kaplan-Meier法进行生存分析,并用Cox比例风险模型确定影响生存的因素。采用时间依赖性受试者工作特征曲线、赤池信息量准则及Brier综合评分评价纳入清蛋白的国际预后指数(IPI)、韩国预后指数(KPI)、NK细胞淋巴瘤预后指数(PINK)模型对患者预后的预测效能。结果治疗前清蛋白预测ENKTL患者预后的最佳临界值为37.5 g/L。>37.5 g/L组(126例)3、5年总生存(OS)率为66.2%、60.3%,无进展生存(PFS)率为58.8%、49.6%;≤37.5 g/L组(58例)3、5年OS率为35.0%、32.4%,PFS率为32.5%、30.0%;>37.5 g/L组OS、PFS均优于≤37.5 g/L组(均P<0.001)。PSM后,>37.5 g/L组OS、PFS仍均优于≤37.5 g/L组(均P=0.002)。多因素分析显示,清蛋白是影响ENKTL患者OS(RR=0.419,95%CI 0.266~0.660,P<0.001)、PFS(RR=0.493,95%CI 0.322~0.755,P<0.001)的独立因素。PSM后,清蛋白仍是影响ENKTL患者OS(RR=0.305,95%CI 0.156~0.598,P=0.001)、PFS(RR=0.341,95%CI 0.185~0.627,P=0.001)的独立因素。纳入清蛋白的IPI、KPI、PINK模型的预后预测效能均提高。结论治疗前清蛋白是评估ENKTL预后的重要因素。Objective To explore the prognostic value of pretreatment albumin in extranodal nasal type NK/T cell lymphoma(ENKTL).Methods The clinical data of 184 ENKTL patients in Shanxi Province Cancer Hospital from January 2002 to December 2018 were retrospectively analyzed.The Contal-O'Quigley change point method was used to determine the optimal cut-off value of albumin for predicting the prognosis of patients.The propensity score matching(PSM)was used to minimize selection biases.The Kaplan-Meier method was used for survival analysis,and Cox proportional hazards model was used to determine the factors affecting survival.The time-dependent receiver operating characteristic curve,Akaike information criterion and integrated Brier score were used to evaluate the efficacy of international prognostic index(IPI),Korean prognostic index(KPI)and prognostic index of NK cell lymphoma(PINK)models incorporating albumin for predicting the prognosis of patients.Results The optimal cut-off value of pretreatment albumin for predicting the prognosis of ENKTL patients was 37.5 g/L.The 3-year and 5-year overall survival(OS)rates in>37.5 g/L group(126 cases)were 66.2%and 60.3%,and the progression-free survival(PFS)rates were 58.8%and 49.6%;the 3-year and 5-year OS rates in≤37.5 g/L group(58 cases)were 35.0%and 32.4%,and the PFS rates were 32.5%and 30.0%.The OS and PFS in>37.5 g/L group were better than those in≤37.5 g/L group(both P<0.001).After PSM,the OS and PFS in>37.5 g/L group were still better than those in≤37.5 g/L group(both P=0.002).Multivariate analysis showed that albumin was an independent influencing factor for OS(RR=0.419,95%CI 0.266-0.660,P<0.001)and PFS(RR=0.493,95%CI 0.322-0.755,P<0.001).After PSM,albumin was still an independent influencing factor for OS(RR=0.305,95%CI 0.156-0.598,P=0.001)and PFS(RR=0.341,95%CI 0.185-0.627,P=0.001).The prognostic prediction performance of the IPI,KPI and PINK models incorporating albumin were all improved.Conclusions Pretreatment albumin is an important prognostic indicator for ENKTL

关 键 词：清蛋白 淋巴瘤 结外NK/T细胞 预后 

分 类 号：R739.62[医药卫生—肿瘤]