CAJ | 학술논문

目的：探讨弥漫大B细胞淋巴瘤患者在首次诊断时外周血淋巴细胞绝对数（absolute lymphocyte count，ALC）与其临床特征及预后之间的关系。方法：回顾性的分析天津医科大学肿瘤医院2002年2月至2008年4月收治143例初治弥漫大B细胞淋巴瘤患者的临床特征及预后，分析不同ALC水平与患者各临床特征之间的关系。结果：将143例弥漫大B细胞淋巴瘤患者分为高ALC（ALC≥1.0×109/L）组和低ALC（ALC<1.0×109/L）组，低ALC组患者常伴随B症状、高IPI评分、Ann Arbor分期较晚以及乳酸脱氢酶水平、β2-微球蛋白水平升高（P<0.05）。而且高ALC组患者的缓解率比低ALC组高（P=0.003）。多因素分析显示Ann ArborⅢ/Ⅳ期、ALC<1.0×109/L是弥漫大B细胞淋巴瘤患者预后较差的独立因素。ALC降低组常伴有Ann Arbor分期的升高。结论：ALC是弥漫大B细胞淋巴瘤患者新的独立预后因素。
목적：탐토미만대B세포림파류환자재수차진단시외주혈림파세포절대수（absolute lymphocyte count，ALC）여기림상특정급예후지간적관계。방법：회고성적분석천진의과대학종류의원2002년2월지2008년4월수치143례초치미만대B세포림파류환자적림상특정급예후，분석불동ALC수평여환자각림상특정지간적관계。결과：장143례미만대B세포림파류환자분위고ALC（ALC≥1.0×109/L）조화저ALC（ALC<1.0×109/L）조，저ALC조환자상반수B증상、고IPI평분、Ann Arbor분기교만이급유산탈경매수평、β2-미구단백수평승고（P<0.05）。이차고ALC조환자적완해솔비저ALC조고（P=0.003）。다인소분석현시Ann ArborⅢ/Ⅳ기、ALC<1.0×109/L시미만대B세포림파류환자예후교차적독립인소。ALC강저조상반유Ann Arbor분기적승고。결론：ALC시미만대B세포림파류환자신적독립예후인소。
Objective: We investigated the clinical significance and prognostic value of peripheral blood absolute lymphocyte count (ALC) in the diagnosis of diffuse large B-cell lymphoma. Methods:The medical records of 143 patients with diffuse large B-cell lymphoma were reviewed. These patients were diagnosed and underwent surgery in Tianjin Medical University Cancer Institute and Hospital, China, between February 2002 and April 2008. The correlation between different ALC levels and clinical features was statisti-cally analyzed. Results:Patients with low ALC (<1.0×109/L) at diagnosis showed B symptoms, an international prognostic index score of ≥2, advanced clinical stage (Ann Arbor III/IV), high lactate dehydrogenase level, and high β2-microglobulin level (P<0.05). Pa-tients with high ALC (≥1.0 × 109/L) responded well to treatment (P=0.003). In multivariate analysis, Ann Arbor stage and ALC level were independent prognostic factors of patients with diffuse large B-cell lymphoma. Patients with low ALC often exhibited advanced clinical stage (Ann ArborⅢ/Ⅳ). Conclusions:ALC level obtained at diagnosis is a novel, powerful prognostic factor of diffuse large B-cell lymphoma.