高龄弥漫大B细胞淋巴瘤患者的临床特征及预后分析  

Clinical Characteristics and Prognosis of Elderly Patients with Diffuse Large B-cell Lymphoma

作　　者：王瑞[1] 谷景荣[1] 洪英霞[1] WANG Rui;GU Jingrong;HONG Yingxia(The First Affiliated Hospital of Zhengzhou University,Zhengzhou,450000)

机构地区：[1]郑州大学第一附属医院,450000

出　　处：《实用癌症杂志》2023年第3期465-467,471,共4页The Practical Journal of Cancer

摘　　要：目的 探讨高龄弥漫大B细胞淋巴瘤(DLBCL)患者的临床特征及预后。方法 选取80例高龄DLBCL患者为研究对象,分析其临床特征。所有患者均随访2年,依据其临床结局将其分为生存组(n=60)与死亡组(n=20),收集年龄、性别等相关资料,运用多因素Logistic回归分析模型探究影响高龄DLBCL患者预后的因素。结果 高龄DLBCL患者的病变可累及全身与各器官,侵犯部位以淋巴结[45.00%(36/80)]最为常见,其次为胃[20.00%(16/80)]、骨髓[12.50%(10/80)]、脾脏[7.50%(6/80)]、肠道[6.25%(5/80)]等。单因素分析显示:性别、体重指数(BMI)、化疗方案与高龄DLBCL患者的预后无关,差异无统计学意义(P>0.05);年龄、国际预后指数(IPI)评分、结外器官受累数目、合并症与高龄DLBCL患者的预后有关,差异有统计学意义(P<0.05);多因素Logistic回归分析显示:年龄>90岁(β=1.743,OR:5.714,95%CI=1.825~17.897)、IPI评分3~4分(β=2.485,OR=12.000,95%CI=3.467~41.540)、结外器官受累数目≥2处(β=3.121,OR=22.667,95%CI=5.698~90.170)、合并症≥2种(β=1.946,OR=7.000,95%CI=2.210~22.172)为高龄DLBCL患者预后的主要影响因素(P<0.05)。结论 DLBCL可累及全身各个部位,高龄DLBCL患者侵犯部位以淋巴结、胃最为多见,预后不良的相关影响因素较多,如年龄>90岁、IPI评分3~4分、结外器官受累数目≥2处、合并症等,临床需对上述因素予以高度重视,及时施行个体化干预措施,以改善预后。Objective To investigate the clinical characteristics and prognosis of elderly patients with diffuse large B-cell lymphoma(DLBCL).Methods 80 elderly patients with DLBCL were selected as the research objects, and their clinical characteristics were analyzed.All patients were followed up for 2 years.According to their clinical outcomes, they were divided into survival group(n=60) and death group(n=20).Relevant data such as age and gender were collected.Multivariate logistic regression analysis model was used to explore the factors affecting the prognosis of elderly patients with DLBCL.Results The lesions of 80 elderly patients with DLBCL could involve the whole body and various organs.The most common sites of invasion were lymph nodes [45.00%(36/80)],followed by stomach [20.00%(16/80)],bone marrow [12.50%(10/80)],spleen [7.50%(6/80)],intestine [6.25%(5/80)];Univariate analysis showed that gender, body mass index(BMI) and chemotherapy regimen were not related to the prognosis of elderly patients with DLBCL,and the difference was not statistically significant(P>0.05);Age, international prognostic index(IPI) score, the number of extranodal organs involved, and complications were related to the prognosis of elderly patients with DLBCL,and the difference was statistically significant(P<0.05);Multivariate logistic regression analysis showed that: age > 90 years old(β=1.743,or: 5.714,95%ci=1.825~17.897),IPI score 3~4 points(β=2.485,or=12.000,95%ci=3.467~41.540),the number of extranodal organs involved ≥ 2(β=3.121,or=22.667,95%ci=5.698~90.170),complications ≥ 2(β=1.946,or=7.000,95% ci=2.210~22.172) were the main prognostic factors of elderly patients with DLBCL(P<0.05).Conclusion DLBCL can affect all parts of the body.Lymph nodes and stomach are the most common sites of invasion in elderly patients with DLBCL.There are many factors related to poor prognosis, such as age > 90 years old, IPI score 3-4,number of extranodal organ involvement ≥ 2,complications, etc.clinical attention should be paid to the above factor

关 键 词：弥漫大B细胞淋巴瘤 临床特征 预后 影响因素 

分 类 号：R733.4[医药卫生—肿瘤]