摘要
【目的】探讨原发性胃弥漫大B细胞淋巴瘤（PG—DLBCL）的生存情况及预后影响因素。【方法】回顾分析41例PG-DLBCL患者的临床资料，应用Kaplan—Meier法进行生存分析及单因素分析。【结果】41例PG-DL—BCL患者1年、2年、3年总生存率分别为77．3％、62．8％、62．8％。单纯手术治疗预后不良；化疗6周期以上的PG-DLBCL患者，单纯化疗与手术联合化疗的生存率相比较差异无显著性（P〉0．05）；化疗6周期以上者生存率明显高于化疗6周期以下者（P〈0．05）；R—CHOP化疗方案预后优于CHOP方案。单因素分析显示B症状、Lugano分期的ⅡE～Ⅳ期、国际预后指数（IPI）评分3～5分、外周血中性粒细胞与淋巴细胞比值（NLR）≥3．5、CA125增高、乳酸脱氢酶（LDH）升高是PG-DLBCL患者预后不良的影响因素（P〈0．05）。【结论】B症状、LuganoⅡE～Ⅳ期、IPI3～5分、外周血NLR≥3．5、CA125增高、LDH水平升高是PG-DLBCL预后不良的影响因素。治疗上推荐以化疗为主的方案，化疗疗程在6周期以上及加用利妥昔单抗的化疗方案可改善患者预后。
[Objective ]To analyze the clinical characteristics, survival and prognostic factors of primary gastric diffuse large B-cell lymphoma （PG-DLBCL）. [Methods]The clinical data of 41 patients with PG-DLBCL were retrospectively analyzed, we applied Kaplan-Meier to estimate the survival time of all patients. [Results] Among the 41 patients, the OS （overall survival） rate at 1- , 3- , and 5 years were 77.3%, 62.8%, 55.0%, respectively. Patients with surgery alone had very poor diagnosis. In PG-DLBCL patient with over 6 cycles of chemotherapy, there was no significant difference in the survival rate between chemotherapy alone and surgery combined chemo- therapy （ P 〉0.05）. Patients with more than 6 cycles of chemotherapy had a significantly higher survival rate than patients under chemotherapy for 6 cycles（ P 〈0.05）. The prognosis of R-CHOP chemotherapy was better than CHOP. Univariate analysis showed that B-symptoms, Lugano stage ⅡE- Ⅳ, IPI （International Prognosis Index） score of 3-5 points, peripheral blood NLR ≥ 3.5, high CA125 , and LDH levels were predictors for poor prognosis in patients with PG-DLBCL（ P 〈0.05）. [Conclusion]B symptoms, Lugano staging of Ⅱ E- Ⅳ, IPI score of 3 5 points, peripheral blood NLR≥3.5, increased CA125, and elevated LDH level were important influencing factors for poor prognosis of PG-DLBCL（ P 〈0.05）.Chemotherapy-based treatment program is recommended.Chemotherapy regimen of more than 6 cycles and chemotherapy with rituximab can improve the prognosis of patients..
作者
黄凤祥
刘畅
吕桂阳
莫钦丽
马劼
彭志刚
HUANG Feng-xiang;LIU Chang;LV Gui-yang(Department of Hematology,First Affiliated Hospital of Guangxi Medical University ,Nanning ,Guangxi Province ,530021 China)
出处
《医学临床研究》
CAS
2018年第5期853-855,共3页
Journal of Clinical Research
关键词
淋巴瘤
大B细胞
弥漫性
胃肿瘤
存活率
预后
危险因素
Lymphoma
Large B-Cell
Diffuse
Stomach Neoplasms
Survival Rate
Prognosis
Risk Factors
