不同HDAC水平的外周T细胞淋巴瘤患者预后复发的影响因素分析  

Prognostic Factors Affecting Recurrence in Peripheral T-Cell Lymphoma Patients with Different HDAC Levels

作　　者：李英新 李一丹 王佩 焦会杰 李英 张静[1] 原现华 LI Ying-Xin;LI Yi-Dan;WANG Pei;JIAO Hui-Jie;LI Ying;ZHANG Jing;YUAN Xian-Hua(Department of Hematology,The First Affiliated Hospital of Xingtai Medical College,Xingtai 054000,Hebei Province,China)

机构地区：[1]邢台医学高等专科学校第一附属医院血液科,河北邢台054000

出　　处：《中国实验血液学杂志》2024年第3期733-741,共9页Journal of Experimental Hematology

基　　金：邢台市重点研发计划自筹项目(2021ZC188)。

摘　　要：目的:基于潜在类别分析不同组蛋白去乙酰化酶(HDAC)水平的外周T细胞淋巴瘤(PTCL)患者预后复发的影响因素分布特征。方法:选取2012年9月至2019年9月在本院就诊的PTCL患者112例,将患者分为复发组和未复发组,比较两组患者的临床资料。通过多因素Logistic回归分析影响患者预后复发的危险因素。采用潜在类别分析法比较复发高风险组与复发低风险组间预后复发影响因素的分布特征差异。结果:复发组患者87例(77.68%),未复发组患者25例(22.32%)。多因素Logistic回归分析结果显示,ECOG评分≥2分、Ann Arbor分期为III-IV期、IPI评分>2分、骨髓受累、血清β2-微球蛋白(β2-MG)水平升高、近期疗效未达到完全缓解(CR)和部分缓解(PR)、HDAC高表达为患者复发的独立危险因素(P<0.05)。HDAC高水平患者的复发率明显高于HDAC低水平患者(P<0.05)。聚类分析结果显示,预后复发风险呈明显聚集性,可将患者分为预后复发高风险组(HDAC>5分)和低风险组(HDAC≤5分)。潜在类别分析结果显示,与预后复发低风险组相比,预后复发高风险组中“危险因素分布较多型”占比较高(P<0.05)。结论:不同HDAC水平的PTCL患者的预后复发情况以及预后复发高风险与低风险人群中危险因素分布特征均有差异。Objective:To analyze the distribution characteristics of prognostic factors affecting recurrence in peripheral T-cell lymphoma(PTCL)patients with different levels of histone deacetylase(HDAC)based on latent class analysis.Methods:112 PTCL patients who were treated in our hospital from September 2012 to September 2019 were selected and divided into recurrence group and non-recurrence group.The clinical data of the two groups of patients were compared.Multivariate logistic regression was used to analyze the risk factors for recurrence.Latent class analysis was used to compare the distribution characteristics of prognostic factors affecting recurrence between the high-risk group and the low-risk group.Results:There were 87 patients(77.68%)in recurrence group and 25 patients(22.32%)in non-recurrence group.The result of multivariate logistic regression showed that ECOG score≥2,Ann Arbor stage III-IV,IPI score>2,bone marrow involvement,elevated serumβ2-microglobulin(β2-MG),short-term efficacy not reaching complete remission(CR)or partial remission(PR),and the high expression of HDAC were all independent risk factors for recurrence in patients with PTCL(P<0.05).The recurrence rate of patients with high HDAC levels was significantly higher than that of patiens with low HDAC levels(P<0.05).The results of cluster analysis showed that the risk of recurrence was obviously clustered,and the patients could be divided into high recurrence risk group(HDAC>5 points)and low recurrence risk group(HDAC≤5 points).The results of latent class analysis showed that patients with multiple risk factors account for a higher proportion in the high recurrence risk group,compared with the low recurrence risk group(P<0.05).Conclusion:There are differences in recurrence rates among PTCL patients with different HDAC levels and in distribution characteristics of risk factors between high recurrence risk and low recurrence risk groups.

关 键 词：组蛋白去乙酰化酶 外周T细胞淋巴瘤 复发 危险因素 分布特征 

分 类 号：R733.1[医药卫生—肿瘤]