CAJ | 학술논문

目的探讨弥漫大B细胞淋巴瘤(DLBCL)患者化疗前外周血中性粒细胞/淋巴细胞比值(NLR)与化疗疗效及预后之间的关系.方法回顾性分析51例经病理活检及免疫组织化学诊断为DLBCL,并接受CHOP或R-CHOP方案化疗患者的临床病理资料,根据NLR中位数将患者分为低NLR组(NLR≤2.32)和高NLR组(NLR＞ 2.32),分析两组患者化疗后完全缓解(CR)及总体生存(OS)情况.计数资料的比较采用x 2检验,生存分析采用Kaplan-Meier法和Log-rank检验,危险因素分析采用Cox比例风险回归模型.结果低NLR组化疗后CR率为71.4％(20/28),高NLR组为39.1％(9/23),差异有统计学意义(P=0.02).低NLR组1、2、3年总体累积生存率分别为96.4％、90.4％和72.3％,高NLR组分别为63.9％、52.7％和42.2％,差异有统计学意义(P=0.009).Cox多因素分析结果显示,化疗前外周血NLR＞ 2.32是影响预后的独立因素(P=0.016).结论化疗前外周血NLR偏高提示患者疗效不佳,预后不良,是影响DLBCL患者生存情况的独立危险因素.
목적 탐토미만대B세포림파류(DLBCL)환자화료전외주혈중성립세포/림파세포비치(NLR)여화료료효급예후지간적관계.방법 회고성분석51례경병리활검급면역조직화학진단위DLBCL,병접수CHOP혹R-CHOP방안화료환자적림상병리자료,근거NLR중위수장환자분위저NLR조(NLR≤2.32)화고NLR조(NLR＞ 2.32),분석량조환자화료후완전완해(CR)급총체생존(OS)정황.계수자료적비교채용x 2검험,생존분석채용Kaplan-Meier법화Log-rank검험,위험인소분석채용Cox비례풍험회귀모형.결과 저NLR조화료후CR솔위71.4％(20/28),고NLR조위39.1％(9/23),차이유통계학의의(P=0.02).저NLR조1、2、3년총체루적생존솔분별위96.4％、90.4％화72.3％,고NLR조분별위63.9％、52.7％화42.2％,차이유통계학의의(P=0.009).Cox다인소분석결과현시,화료전외주혈NLR＞ 2.32시영향예후적독립인소(P=0.016).결론 화료전외주혈NLR편고제시환자료효불가,예후불량,시영향DLBCL환자생존정황적독립위험인소.
Objective To explore the neutrophil to lymphocyte ratio (NLR) and its relationship with the effect of chemotherapy and prognosis in patients with diffuse large B-cell lymphoma (DLBCL).Methods The clinicopathological characteristics and outcome of 51 patients with DLBCL diagnosed by pathological biopsy and immunohistochemistry who received CHOP or R-CHOP regimen were collected and reviewed.According to the median of NLR,the patients were divided into low NLR group (NLR≤2.32) and high NLR group (NLR＞2.32).The prognostic influence of the NLR on overall survival (OS) was studied by Kaplan-Meier method and Log-rank test.To evaluate the independent prognostic relevance of NLR,univariate and multivariate Cox regression models were applied.Results The complete response (CR) rates of the low and high NLR groups were 71.4 ％ (20/28) and 39.1％ (9/23),respectively (P =0.02).The OS in the low NLR group was significantly better than that in the high NLR group (1,2 and 3-year OSs were 96.4 ％,90.4 ％ and 72.3 ％ vs 63.9 ％,52.7 ％ and 42.2 ％,respectively,P =0.009).Univariate and multivariate Cox regression models analysis showed that NLR ＞ 2.32 was an independent prognostic factor (P =0.016).Conclusion An elevated NLR before treatment indicates the poor effect of chemotherapy and prognosis of patients.NLR is an independent prognostic factor for DLBCL.