CAJ | 학술논문

目的探讨血清β2-微球蛋白(β2-MG)水平与国际预后指数(IPI)的关系,及其对外周T细胞淋巴瘤( PTCL)预后判断的应用价值,为个体化治疗提供依据.方法回顾性分析采用CHOP方案治疗的81例PTCL的临床资料,对β2-MG水平、IPI评分系统与疗效及远期生存的关系进行统计学分析.结果全组81例患者,均接受CHOP方案联合化疗,总有效(RR)率为82.7％,完全缓解(CR)率53.1％.IPI评分低危组、低中危组、中高危组及高危组的RR率分别为95.7％、87.5％、53.8％和20.0％,CR率分别为74.5％、37.5％、15.4％和0,各组间差异均有统计学意义(均P＜ 0.05).中位随访时间30个月(2 ～ 98个月),中位生存期(MST) 31.2个月,总的1、3、5年生存(OS)率分别为83.5％、41.8％和34.7％.低危和低中危组MST目前尚未达到,中高危和高危组MST分别为16、7个月,5年OS率分别为57.3％、55.9％、0和0,差异有统计学意义(P＜0.05).将IPI评分0～1分和2分合并为低危组,3分、4～5分合并为高危组,进行生存比较,前者MST尚未达到,后者为1 1个月,5年OS率分别为54.8％和0(P＜0.05).高危组血清β2- MG水平均较低危组明显升高,高危组患者较低危组患者血清β2-MG异常者比例也明显升高(均P＜0.05).多因素分析结果显示血清β2- MG水平、IPI评分与PTCL的预后密切相关(P＜0.05).结论血清β2- MG水平可以和IPI评分系统一起用于外周T细胞淋巴瘤患者的预后判断.
목적 탐토혈청β2-미구단백(β2-MG)수평여국제예후지수(IPI)적관계,급기대외주T세포림파류( PTCL)예후판단적응용개치,위개체화치료제공의거.방법 회고성분석채용CHOP방안치료적81례PTCL적림상자료,대β2-MG수평、IPI평분계통여료효급원기생존적관계진행통계학분석.결과 전조81례환자,균접수CHOP방안연합화료,총유효(RR)솔위82.7％,완전완해(CR)솔53.1％.IPI평분저위조、저중위조、중고위조급고위조적RR솔분별위95.7％、87.5％、53.8％화20.0％,CR솔분별위74.5％、37.5％、15.4％화0,각조간차이균유통계학의의(균P＜ 0.05).중위수방시간30개월(2 ～ 98개월),중위생존기(MST) 31.2개월,총적1、3、5년생존(OS)솔분별위83.5％、41.8％화34.7％.저위화저중위조MST목전상미체도,중고위화고위조MST분별위16、7개월,5년OS솔분별위57.3％、55.9％、0화0,차이유통계학의의(P＜0.05).장IPI평분0～1분화2분합병위저위조,3분、4～5분합병위고위조,진행생존비교,전자MST상미체도,후자위1 1개월,5년OS솔분별위54.8％화0(P＜0.05).고위조혈청β2- MG수평균교저위조명현승고,고위조환자교저위조환자혈청β2-MG이상자비례야명현승고(균P＜0.05).다인소분석결과현시혈청β2- MG수평、IPI평분여PTCL적예후밀절상관(P＜0.05).결론 혈청β2- MG수평가이화IPI평분계통일기용우외주T세포림파류환자적예후판단.
Objective To determine the relationship between the serum level of β2-microglobin (β2-MG)and international prognostic index (IPI) and investigate the role of IPI in predicting the prognosis and making individualized therapy for peripheral T-cell lymphoma (PTCL).Methods Eighty-one patients with PTCL were treated by standard CHOP regimen.The clinical characteristics,response,long-term surival rates and the relationship between serum level of β2-MG and IPI scores were analyzed retrospectively.Results Eighty-one patients were eligible.All of them were treated by CHOP regimen.The overall response rate (RR) was 82.7 ％ with 53.1％ complete remission (CR) rate.The RR of IPI low risk,low-intermediate risk,high-intermediate risk,and high risk were 95.7 ％,87.5 ％,53.8 ％ and 20.0 ％,with CR rate 74.5 ％,37.5 ％,15.4 ％ and 0,respectively (P ＜0.05).The median survival times (MST) were 31.2 months at a median follow-up of 30 months (2-98 months).The acturial 1-,3-,and 5-year overall survival (OS) rates were 83.5 ％,41.8 ％ and 34.7 ％,respectively.The 5-year OS rates of low risk,low-intermediate risk,high-intermediate risk,high risk were 57.3 ％,55.9 ％,0 and 0,respectively (P ＜0.05).The OS rates of low risk group (IPI 0-2 scores) and high risk group (IPI 3-5 scores) were 54.8 ％ and 0,respectively (P ＜0.05).Serum levels of β2-MG were significantly elevated in the high risk group than those in the low risk group.The proportion of abnormal serum level of [β2-MG were also significantly elevated in the high risk group than those in the low risk group.The results of multivariante analysis showed that serum level of β2-MG and IPI scores were independent prognostic factors for PTCL (P＜0.05).Conclusion The serum level of β2-MG with IPI scores system can be uscd for evaluating the prognosis of PTCL patients.