223例初治霍奇金淋巴瘤患者临床特征及预后因素分析  

Analysis of Clinical Characteristics and Prognostic Factors of 223 Newly Diagnosed Hodgkin's Lymphoma Patients

作　　者：刘素[1] 马静[1] 岳园芳 李倩[1] 杨洪亮[1] 于泳[1] 王晓芳[1] 赵志刚[1] 王亚非[1] 张翼鷟[1] 

机构地区：[1]天津医科大学肿瘤医院血液肿瘤科,国家肿瘤临床医学研究中心,天津市肿瘤重点防治实验室,天津300060

出　　处：《中国实验血液学杂志》2015年第5期1296-1300,共5页Journal of Experimental Hematology

摘　　要：目的:分析初治霍奇金淋巴瘤(Hodgkin's lymphoma,HL)患者临床特征及预后相关因素。方法:收集本院2001年1月至2012年12月诊治的223例HL患者的临床资料,一般特点、实验室检查、临床表现以及近期疗效;并通过Log-rank检验及Cox比例风险模型分析上述因素与预后的相关性;所有数据均使用SPSS19.0及graphPad Prism 5软件进行分析。结果:223例初治HL患者男女比例为1.25∶1;中位年龄40(3-84)岁,中位生存期为62(8-189)个月,5年总生存(overall survival,OS)率为92.8%。多因素生存分析显示,起病于纵隔淋巴结区域、有结外受累、血清乳酸脱氢酶(LDH)水平升高、CR2未达CR/CRu为独立不良预后因素(P<0.05)。依照患者是否具备上述不良预后因素,将本研究223例HL患者分为低危组、中危组、高危组,3组HL患者5年OS率分别为:100%、96.9%、42.9%,各组间OS均具有显著差异(P<0.05)。结论:HL好发于青年男性患者,疗效好、生存期长;起病于纵隔淋巴结区域、有结外受累、LDH水平升高、CR2未达CR/CRu为独立不良预后因素;根据初治HL患者是否具有上述指标,进行不同危险度分层,能在一定程度上预测初治HL患者的预后。Objective : To analyze the clinical characteristics and prognostic factors of the newly diagnosed Hodgkin's lymphoma( HL) patients. Method: The clinical data of 223 patients with pathologically confirmed and newly diagnosed HL( since January 2001 to December 2012) were collected from Tianjin Medical University Cancer Hospital.The patients' route features,laboratorial examination results,clinical manifestations and short-term efficacy were analyzed. Furthermore,the Log-rank test and Cox proportional hazard model were applied to analyze the prognosis. All data were analyzed with SPSS software version 1. 0 and graphPad Prism 5. Results: Among the 223 newly diagnosed HL patients,the ratio of male to female was approximately 1. 25∶ 1 and the median age was 40 years old( range 3- 84years). The median survival period is 62 months( range 8- 189 months). The 5-year overall survival( OS) rate was92. 8% for all 223 HL patients. Multivariate analysis showed that HL originated from mediastinal lymph node region,the extranodal sites were involved,lactate dehydrogenase( LDH) level increased and CR2 was unable to fulfil the CR/CRu which are independent prognostic factors of HL patients( P < 0. 05). Therefore,according to the above-mentioned adverse prognostic factors,223 cases of HL patients were regrouped as low,intermediate and high risk. The HL 5-year OS rate of three groups were 100%,96. 9% and 42. 9%,OS in each group was significantly different( P < 0. 05).Conclusion: HL displays a high incidence in young male patients but the curative efficacy is optimal and the survival period is long. The HL originated at mediastinal lymph node region,involved extranodal sites,lactate dehydrogenase( LDH) level increased and CR2 is unable to fulfil the CR/CRu which are independent prognostic factors of HL patients.According to the above-mentioned factors for the initial treatment of patients with HL,risk discrimination can predict the prognosis of patients with HL to a certain extent.

关 键 词：霍奇金淋巴瘤 临床特征 预后因素 

分 类 号：R733.1[医药卫生—肿瘤]