中国肿瘤临床
中國腫瘤臨床
중국종류림상
Chinese Journal of Clinical Oncology
2015年
21期
1050-1055
,共6页
宋腾%王华庆%张会来%钱正子%周世勇%邱立华%李兰芳%宋拯
宋騰%王華慶%張會來%錢正子%週世勇%邱立華%李蘭芳%宋拯
송등%왕화경%장회래%전정자%주세용%구립화%리란방%송증
弥漫大B细胞淋巴瘤%国际预后指数%预后%利妥昔单抗
瀰漫大B細胞淋巴瘤%國際預後指數%預後%利妥昔單抗
미만대B세포림파류%국제예후지수%예후%리타석단항
diffuse large B-cell lymphoma(DLBCL)%International Prognostic Index(IPI)%prognosis%rituximab
目的：验证改良国际预后指数（NCCN-IPI）对弥漫大B细胞淋巴瘤（DLBCL）患者免疫化疗后的预后评估价值。方法：回顾性分析天津医科大学肿瘤医院2008年1月至2013年1月收治的168例初治DLBCL患者的临床特征及预后，采用NCCN-IPI和国际预后指数（IPI）进行危险度分层和预后评估。结果：全组患者中位年龄58（24～80）岁，男性92例（54.8%），Ann Arbor分期Ⅲ～Ⅳ期94例（56.0%），ECOG PS≥2分19例（11.3%）；发病时LDH水平升高（>245 U/L）占71.4%。中位随访42（15～88）个月，3年和5年生存率（OS）分别为（75.9±3.4）%、（65.1±5.2）%。全组患者根据IPI评分系统，低危组占30.4%，中低危27.4%，中高危25.0%，高危17.3%；3年OS分别为91.8%、76.7%、67.9%和47.1%。根据NCCN-IPI评分，低危组19.0%，中低危38.1%，中高危31.5%，高危11.3%。3年OS分别为94.5%、85.4%、61.2%和38.1%。与IPI评分相比，NCCN-IPI评分区分高危和低危患者的能力更强（NCCN-IPI：3年OS：94.5%vs.38.1%；IPI：91.8%vs.47.1%）。结论：在利妥昔单抗一线治疗中，与IPI指数相比，NCCN-IPI更好地整合了年龄和LDH水平两个变量的预后作用，可作为DLBCL患者强有力的预后分层工具。
目的：驗證改良國際預後指數（NCCN-IPI）對瀰漫大B細胞淋巴瘤（DLBCL）患者免疫化療後的預後評估價值。方法：迴顧性分析天津醫科大學腫瘤醫院2008年1月至2013年1月收治的168例初治DLBCL患者的臨床特徵及預後，採用NCCN-IPI和國際預後指數（IPI）進行危險度分層和預後評估。結果：全組患者中位年齡58（24～80）歲，男性92例（54.8%），Ann Arbor分期Ⅲ～Ⅳ期94例（56.0%），ECOG PS≥2分19例（11.3%）；髮病時LDH水平升高（>245 U/L）佔71.4%。中位隨訪42（15～88）箇月，3年和5年生存率（OS）分彆為（75.9±3.4）%、（65.1±5.2）%。全組患者根據IPI評分繫統，低危組佔30.4%，中低危27.4%，中高危25.0%，高危17.3%；3年OS分彆為91.8%、76.7%、67.9%和47.1%。根據NCCN-IPI評分，低危組19.0%，中低危38.1%，中高危31.5%，高危11.3%。3年OS分彆為94.5%、85.4%、61.2%和38.1%。與IPI評分相比，NCCN-IPI評分區分高危和低危患者的能力更彊（NCCN-IPI：3年OS：94.5%vs.38.1%；IPI：91.8%vs.47.1%）。結論：在利妥昔單抗一線治療中，與IPI指數相比，NCCN-IPI更好地整閤瞭年齡和LDH水平兩箇變量的預後作用，可作為DLBCL患者彊有力的預後分層工具。
목적：험증개량국제예후지수（NCCN-IPI）대미만대B세포림파류（DLBCL）환자면역화료후적예후평고개치。방법：회고성분석천진의과대학종류의원2008년1월지2013년1월수치적168례초치DLBCL환자적림상특정급예후，채용NCCN-IPI화국제예후지수（IPI）진행위험도분층화예후평고。결과：전조환자중위년령58（24～80）세，남성92례（54.8%），Ann Arbor분기Ⅲ～Ⅳ기94례（56.0%），ECOG PS≥2분19례（11.3%）；발병시LDH수평승고（>245 U/L）점71.4%。중위수방42（15～88）개월，3년화5년생존솔（OS）분별위（75.9±3.4）%、（65.1±5.2）%。전조환자근거IPI평분계통，저위조점30.4%，중저위27.4%，중고위25.0%，고위17.3%；3년OS분별위91.8%、76.7%、67.9%화47.1%。근거NCCN-IPI평분，저위조19.0%，중저위38.1%，중고위31.5%，고위11.3%。3년OS분별위94.5%、85.4%、61.2%화38.1%。여IPI평분상비，NCCN-IPI평분구분고위화저위환자적능력경강（NCCN-IPI：3년OS：94.5%vs.38.1%；IPI：91.8%vs.47.1%）。결론：재리타석단항일선치료중，여IPI지수상비，NCCN-IPI경호지정합료년령화LDH수평량개변량적예후작용，가작위DLBCL환자강유력적예후분층공구。
Objective: To validate the prognostic value of an enhanced International Prognostic Index (NCCN-IPI) for diffuse large B-cell lymphoma (DLBCL) patients treated with R-CHOP. Methods:A total of 168 DLBCL patients who were initially diagnosed and treated in Tianjin Medical University Cancer Institute and Hospital from January 2008 to January 2013 were included in the study. Baseline characteristics were collected, and survival analysis was performed using the standard IPI and the new NCCN-IPI model. Re-sults:The main clinical features were as follows:mean age was 58 (range:24-80) years old, 54.8%of them were male, 56%were stageⅢ/Ⅳdisease, 11.3%were Eastern Cooperative Oncology Group Performance Status (ECOG PS)≥2, and 71.4%had elevated lactate de-hydrogenase level (>245 U/L). After a median follow-up of 42 (range: 15-88) months, the 3- and 5-year overall survival (OS) rates were 75.9%± 3.4%and 65.1%± 5.2%, respectively. According to the old IPI risk categorization, 30.4%, 27.4%, 25.0%, and 17.3%pa-tients belonged to the four risk subgroups (low, low-intermediate, high-intermediate, and high). The corresponding percentages were 19.0%, 38.1%, 31.5%, and 11.3%in the NCCN-IPI model. The 3-year OS for the four NCCN-IPI risk groups were 94.5%, 85.4%, 61.2%, and 38.1%, respectively, whereas the rates were 91.8%, 76.7%, 67.9%, and 47.1%for the IPI risk groups. Compared with the IPI, the NCCN-IPI better discriminated low-and high-risk subgroups (3-year OS:94.5%vs. 38.1%) than the IPI (3-year OS:91.8%vs. 47.1%), respectively. Conclusion: Compared with IPI, NCCN-IPI better incorporated two known prognostic variables, i.e., age and LDH, and was thus a more powerful prognosticator for DLBCL patients in the rituximab-based era.
