血小板⁃淋巴细胞比率在原发性中枢神经系统淋巴瘤患者中的预后意义  

The prognostic implication of the platelet⁃lymphocyte ratio in patients with primary central nervous system lymphoma

作　　者：郭婧冉 杜凯欣 梁金花[1] 吴佳竹[1] 王莉[1] 徐卫[1] GUO Jingran;DU Kaixin;LIANG Jinhua;WU Jiazhu;WANG Li;XU Wei(Department of Hematology,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学第一附属医院血液科,江苏南京210029

出　　处：《南京医科大学学报（自然科学版）》2023年第4期518-524,541,共8页Journal of Nanjing Medical University(Natural Sciences)

基　　金：国家自然科学基金(81770166)。

摘　　要：目的:探讨血小板⁃淋巴细胞比值(platelet⁃lymphocyte ratio,PLR)在原发性中枢神经系统淋巴瘤(primary central ner⁃vous system lymphoma,PCNSL)中的预后作用,寻找适合亚洲PCNSL人群的改良国际结外淋巴瘤研究组(International Extranod⁃al Lymphoma Study Group,IELSG)评分系统。方法:回顾性分析2011年6月—2021年12月于南京医科大学第一附属医院就诊的72例原发中枢神经系统弥漫大B细胞淋巴瘤(diffuse large B⁃cell lymphoma,DLBCL)患者的临床资料,采用Kaplan⁃Meier法、单因素和多因素Cox回归分析等进行生存分析和预后因素评估。结果:PCNSL患者的中位无进展生存期(progression⁃free survival,PFS)和总生存期(overall survival,OS)分别为17个月和39个月。单因素Cox回归分析证实PLR≥107(P=0.022,P=0.038)、年龄≥54岁(P=0.043,P=0.027)、乳酸脱氢酶(lactate dehydrogenase,LDH)/参考值正常上限(upper limit of normal value,ULN)>2(P=0.080,P=0.064)、脑脊液(cerebro⁃spinal fluid,CSF)蛋白/ULN>2(P=0.051,P=0.023)、美国东部肿瘤协作组体能状态(Eastern Cooperative Oncology Group performance status,ECOG)评分≥2(P=0.029,P=0.027)和改良IELSG高危组(P=0.064,P=0.001)与较短的PFS和OS有关。多因素Cox回归分析证实PLR≥107(P=0.011,P=0.022)和ECOG评分≥2(P=0.013,P=0.015)是PCNSL患者PFS和OS的独立危险因素。结论:PLR或可以作为一项评估PCNSL预后的指标。Objective:To explore the prognostic implication of the platelet⁃lymphocyte ratio(PLR)in primary central nervous system lymphoma(PCNSL)and to find a modified IELSG scoring system suitable for the Asian PCNSL population.Methods:The clinical data of 72 patients with PCNSL from the First Affiliated Hospital of Nanjing Medical University between June 2011 and December 2021 were retrospectively analyzed.Kaplan⁃Meier method,univariate and multivariate Cox regression analyses were performed for survival analysis and prognostic factors evaluation.Results:Median progression⁃free survival(PFS)and overall survival(OS)were 17 months and 39 months in PCNSL patients,respectively.Univariate Cox regression analysis confirmed PLR≥107(P=0.022,P=0.038),age 54≥years(P=0.043,P=0.027),LDH/ULN>2(P=0.080,P=0.064),CSF protein/ULN>2(P=0.051,P=0.023),ECOG≥2(P=0.029,P=0.027)and modified IELSG high⁃risk group(P=0.064,P=0.001)were associated with shorter PFS and OS.Multivariate Cox regression analysis confirmed PLR≥107(P=0.011,P=0.022)and ECOG≥2(P=0.013,P=0.015)were independent risk factors for PFS and OS of PCNSL patients.Conclusion:PLR may be used as an indicator to evaluate the prognosis of PCNSL.

关 键 词：原发中枢神经系统淋巴瘤 血小板⁃淋巴细胞比值 真实世界研究 预后 生存 

分 类 号：R733.4[医药卫生—肿瘤]