CD5阳性弥漫大B细胞淋巴瘤患者的临床特征及预后分析  

Clinical Features and Prognosis of Patients with CD5+Diffuse Large B-Cell Lymphoma

作　　者：黄秀娟 杨健 魏小芳 伏媛[3] 赵阳阳 程明霞 李青芬 闫海龙 冯友繁[3] HUANG Xiu-Juan;YANG Jian;WEI Xiao-Fang;FU Yuan;ZHAO Yang-Yang;CHENG Ming-Xia;LI Qing-Fen;YAN Hai-Long;FENG You-Fan(Department of Hematology,Shaanxi Provincial People′s Hospital,Xi′an 710068,Shaanxi Province,China;Department of Surgical Oncology,Gansu Provincial Hospital,Lanzhou 730000,Gansu Province,China;Department of Hematology,Gansu Provincial Hospital,Lanzhou 730000,Gansu Province,China;Department of Emergency Surgery,Shaanxi Provincial People′s Hospital,Xi′an 710068,Shaanxi Province,China)

机构地区：[1]陕西省人民医院血液内科,陕西西安710068 [2]甘肃省人民医院肿瘤外科,甘肃兰州730000 [3]甘肃省人民医院血液科,甘肃兰州730000 [4]陕西省人民医院急诊外科,陕西西安710068

出　　处：《中国实验血液学杂志》2024年第3期750-755,共6页Journal of Experimental Hematology

基　　金：甘肃省自然科学基金(22JR11RA258);甘肃省青年科技基金计划(21JR7RA646);甘肃省人民医院院内科研基金项目(20GSSY1-8)。

摘　　要：目的:分析CD5阳性弥漫大B细胞淋巴瘤(DLBCL)患者的临床特征及预后影响因素。方法:回顾性分析自2013年1月至2020年1月甘肃省人民医院就诊的161例初治DLBCL患者的临床资料,根据CD5表达情况,将患者分为CD5+组和CD5-组,并对两组患者的临床特征、预后生存进行统计学分析。结果:临床特征分析结果显示,CD5+组患者的中位年龄为62岁,高于CD5-组的56岁(P=0.048);CD5+组患者女性占比为62.96%,明显高于CD5-组的41.79%(P=0.043);CD5+组IPI评分>2分患者的比例为62.96%,高于CD5-组患者的40.30%(P=0.031)。生存分析结果显示,CD5+组的中位总生存期和无进展生存期分别为27(3-77)个月、31(3-76)个月,均短于CD5-组的30(5-84)个月、32.5(4-83)个月,比较差异有统计学意义(P=0.047,P=0.026)。单因素分析结果显示,高龄、CD5表达为阳性、初诊时存在三打击或双打击、较高的IPI评分及化疗过程中未使用利妥昔单抗是影响DLBCL患者预后的危险因素,进一步行Cox多因素回归分析结果显示,除高龄外以上均是独立危险因素。结论:CD5+DLBCL患者预后相对CD5-患者更差,此类患者多见于女性,高龄、IPI评分高,是一类特殊的DLBCL亚型。Objective:To analyze the clinical characteristics and prognosis of patients with CD5+diffuse large B-cell lymphoma(DLBCL).Methods:The clinical data of 161 newly treated DLBCL patients in Gansu Provincial Hospital from January 2013 to January 2020 were retrospectively analyzed.According to CD5 expression,the patients were divided into CD5+group and CD5-group.The clinical characteristics and prognosis of the two groups were statistically analyzed.Results:The median age of patients in CD5+group was 62 years,which was higher than 56 years in CD5-group(P=0.048).The proportion of women in CD5+group was 62.96%,which was significantly higher than 41.79%in CD5-group(P=0.043).The proportion of patients with IPI score>2 in CD5+group was 62.96%,which was higher than 40.30%in CD5-group(P=0.031).Survival analysis showed that the median overall survival and progression-free survival time of patients in CD5+group were 27(3-77)and 31(3-76)months,respectively,which were both shorter than 30(5-84)and 32.5(4-83)months in CD5-group(P=0.047,P=0.026).Univariate analysis showed that advanced age,positive CD5 expression,triple or double hit at initial diagnosis,high IPI score and no use of rituximab during chemotherapy were risk factors for the prognosis of DLBCL patients.Further Cox multivariate regression analysis showed that these factors were also independent risk factors except for advanced age.Conclusion:CD5+DLBCL patients have a worse prognosis than CD5-DLBCL patients.Such patients are more common in females,with advanced age and high IPI score,which is a special subtype of DLBCL.

关 键 词：弥漫大B细胞淋巴瘤 CD5 临床特征 预后 

分 类 号：R733[医药卫生—肿瘤]