白血病·淋巴瘤
白血病·淋巴瘤
백혈병·림파류
JOURNAL OF LEUKEMIA & LYMPHOMA
2014年
1期
48-52
,共5页
淋巴瘤%临床特点%预后因素
淋巴瘤%臨床特點%預後因素
림파류%림상특점%예후인소
Lymphoma%Clinical characteristics%Prognostic factors
目的 分析淋巴瘤的临床特点及预后相关因素.方法 对青海地区253例淋巴瘤患者临床资料进行回顾性研究并随访.采用Kaplan-Meier法分析患者不同临床特点及实验室检查的生存期差异.采用Cox比例风险回归模型分析影响预后的因素.结果 253例淋巴瘤患者中,男、女比例为1.56∶1,中位年龄为48岁,发病年龄高峰为40岁和60岁左右.结内起病(56.13％)较多,结外起病常见部位为鼻咽部和胃肠道.病理类型为霍奇金淋巴瘤40例(15.81％),非霍奇金淋巴瘤213例(84.19％).前者以结节硬化型(72.50％)最多见;后者中B细胞淋巴瘤148例(69.48％),最常见的病理类型为弥漫大B细胞淋巴瘤(39.91％)、滤泡细胞淋巴瘤(12.21％)及周围T细胞非特殊型淋巴瘤(9.39％).单因素预后分析显示,临床分期、有无B症状、血红蛋白(Hb)、乳酸脱氢酶(LDH)、国际预后指数(IPI)及治疗方案与非霍奇金淋巴瘤预后密切相关(均P＜0.05).Cox回归模型多因素分析显示,临床分期、IPI及治疗方案与非霍奇金淋巴瘤的预后关系密切,差异有统计学意义(均P＜0.05).结论 青海地区淋巴瘤发病年龄有两个高峰,结内发病高于结外,B细胞淋巴瘤多见,IPI分组适用于该地区非霍奇金淋巴瘤的预后评估,并可作为其独立的预后因素.
目的 分析淋巴瘤的臨床特點及預後相關因素.方法 對青海地區253例淋巴瘤患者臨床資料進行迴顧性研究併隨訪.採用Kaplan-Meier法分析患者不同臨床特點及實驗室檢查的生存期差異.採用Cox比例風險迴歸模型分析影響預後的因素.結果 253例淋巴瘤患者中,男、女比例為1.56∶1,中位年齡為48歲,髮病年齡高峰為40歲和60歲左右.結內起病(56.13％)較多,結外起病常見部位為鼻嚥部和胃腸道.病理類型為霍奇金淋巴瘤40例(15.81％),非霍奇金淋巴瘤213例(84.19％).前者以結節硬化型(72.50％)最多見;後者中B細胞淋巴瘤148例(69.48％),最常見的病理類型為瀰漫大B細胞淋巴瘤(39.91％)、濾泡細胞淋巴瘤(12.21％)及週圍T細胞非特殊型淋巴瘤(9.39％).單因素預後分析顯示,臨床分期、有無B癥狀、血紅蛋白(Hb)、乳痠脫氫酶(LDH)、國際預後指數(IPI)及治療方案與非霍奇金淋巴瘤預後密切相關(均P＜0.05).Cox迴歸模型多因素分析顯示,臨床分期、IPI及治療方案與非霍奇金淋巴瘤的預後關繫密切,差異有統計學意義(均P＜0.05).結論 青海地區淋巴瘤髮病年齡有兩箇高峰,結內髮病高于結外,B細胞淋巴瘤多見,IPI分組適用于該地區非霍奇金淋巴瘤的預後評估,併可作為其獨立的預後因素.
목적 분석림파류적림상특점급예후상관인소.방법 대청해지구253례림파류환자림상자료진행회고성연구병수방.채용Kaplan-Meier법분석환자불동림상특점급실험실검사적생존기차이.채용Cox비례풍험회귀모형분석영향예후적인소.결과 253례림파류환자중,남、녀비례위1.56∶1,중위년령위48세,발병년령고봉위40세화60세좌우.결내기병(56.13％)교다,결외기병상견부위위비인부화위장도.병리류형위곽기금림파류40례(15.81％),비곽기금림파류213례(84.19％).전자이결절경화형(72.50％)최다견;후자중B세포림파류148례(69.48％),최상견적병리류형위미만대B세포림파류(39.91％)、려포세포림파류(12.21％)급주위T세포비특수형림파류(9.39％).단인소예후분석현시,림상분기、유무B증상、혈홍단백(Hb)、유산탈경매(LDH)、국제예후지수(IPI)급치료방안여비곽기금림파류예후밀절상관(균P＜0.05).Cox회귀모형다인소분석현시,림상분기、IPI급치료방안여비곽기금림파류적예후관계밀절,차이유통계학의의(균P＜0.05).결론 청해지구림파류발병년령유량개고봉,결내발병고우결외,B세포림파류다견,IPI분조괄용우해지구비곽기금림파류적예후평고,병가작위기독립적예후인소.
Objective To analyze the clinical features and prognostic factors of lymphoma.Methods The clinical data,pathologic data and survival state of 253 patients with lymphoma in Qinghai were retrospectively studied.The survival differences of patients with different clinical characteristics and laboratory tests were analyzed using Kaplan-Meier method.The prognostic factors of lymphoma were analyzed by Cox proportional hazards regression model.Results Among all of 253 cases of lymphoma,males were in the majority (male∶female =1.56∶1).The median age of patients was 48 years old.There were two peaks of about 40 years old and 60 years old in age of onset.The nodal lymphoma (56.13 ％) was more commonly than the extranodal lymphoma (43.87 ％).The more common extranodal lymphomas were found in the nasopharynx and gastrointestinal tract.Among all cases,40 cases (15.81％) were confirmed to be Hodgkin lymphoma (HL),of which,the commonest subtype was nodular sclerosis (72.5 ％).While 213 of 253 cases (84.19 ％) belonged to non-Hodgkin lymphoma (NHL),of which,B-cell lymphoma was 148 cases (69.48 ％).Overall,three subtypes including diffuse large B-cell lymphoma (39.91％),follicular lymphoma (12.21％) and peripheral T-cell lymphoma (9.39 ％) were the commonest subtypes among all cases.Univariate analysis showed that the clinical stage,B symptoms,Hb concentration,serum LDH level,international prognostic score (IPI) and treatment programs were related to the prognosis of NHL (P ＜ 0.05).However,the Cox regression multivariate analysis showed that only the clinical stage,IPI and treatment programs,not B symptoms,Hb concentration and serum LDH level,were closely related to the prognosis of NHL (P ＜ 0.05).Conclusions In Qinghai area,there are two peaks of about 40 and 60 years old in the age of onset of lymphoma.The nodal lymphoma is more than extranodal lymphoma.B-cell lymphoma is more common.IPI could be as an independent prognostic factor and might be used to estimate the prognosis of NHL.
