血清乳酸脱氢酶、β_(2)-微球蛋白及铁蛋白水平与侵袭性B细胞淋巴瘤患者预后的关系

Relationship between the levels of serum lactate dehydrogenase,β_(2)-microglobulin,ferritin and prognosis in patients with invasive B-cell lymphoma

目的探讨血清乳酸脱氢酶(LDH)、β_(2)-微球蛋白(β_(2)-MG)及铁蛋白水平与侵袭性B细胞淋巴瘤患者预后的关系。方法选取60例侵袭性B细胞淋巴瘤患者,均接受利妥昔单抗+环磷酰胺+表柔比星+长春新碱+泼尼松(R-CHOP)方案化疗,治疗4个疗程后评估临床疗效,检测治疗前后患者血清LDH、β_(2)-MG、铁蛋白水平。随访3年,比较不同预后侵袭性B细胞淋巴瘤患者治疗4个疗程后血清LDH、β_(2)-MG、铁蛋白水平,其与患者预后的相关性采用Spearman秩相关分析。结果60例侵袭性B细胞淋巴瘤患者化疗4个疗程后,完全缓解38例,部分缓解7例,疾病稳定4例,疾病进展11例,疾病控制率为81.67%(49/60)。治疗4个疗程后,侵袭性B细胞淋巴瘤患者血清LDH、β_(2)-MG、铁蛋白水平均明显低于治疗前,差异均有统计学意义(P﹤0.01)。随访3年,所有患者均无失访,生存43例,死亡17例。生存患者治疗4个疗程后血清LDH、β_(2)-MG、铁蛋白水平均明显低于死亡患者,差异均有统计学意义(P﹤0.01)。Spearman秩相关分析结果显示,血清LDH、β_(2)-MG、铁蛋白水平与侵袭性B细胞淋巴瘤患者的预后生存均呈负相关(r=-0.718、-0.823、-0.753,P﹤0.05)。结论血清LDH、β_(2)-MG、铁蛋白水平与侵袭性B细胞淋巴瘤患者的预后生存均呈负相关,有助于临床对患者的预后进行客观评价。

Objective To explore the relationship between serum lactate dehydrogenase(LDH),β_(2)-microglobulin(β_(2)-MG),ferritin levels and prognosis in patients with invasive B-cell lymphoma.Method A total of 60 patients with invasive B-cell lymphoma were selected,all patients received rituximab+cyclophosphamide+epirubicin+vincristine+prednisone(R-CHOP)regimen chemotherapy.The therapeutic effect was evaluated after 4 courses of treatment,and levels of serum LDH,β_(2)-MG,and ferritin levels were detected before and after treatment.Followed up for 3 years,the serum LDH,β_(2)-MG,and ferritin levels in patients with invasive B-cell lymphoma with different prognosis after 4 courses of treatment were compared,and their correlation with patients prognosis was analyzed by Spearman rank correlation analysis.Result After 4 courses of treatment,in 60 patients with invasive B-cell lymphoma,38 cases showed complete response,7 cases showed partial response,4 cases showed stable disease,and 11 cases showed progressive disease,the disease control rate was 81.67%(49/60).After 4 courses of treatment,the serum LDH,β_(2)-MG and ferritin levels in patients with invasive B-cell lymphoma were significantly lower than those before treatment,the differences were statistically significant(P<0.01).Followed up for 3 years,there was no loss of follow-up for all patients,with 43 surviving cases and 17 death cases.The serum LDH,β_(2)-MG,and ferritin levels of surviving patients after 4 courses of treatment were significantly lower than those of death patients,and the differences were statistically significant(P<0.01).Spearman rank correlation analysis results showed that serum LDH,β_(2)-MG,and ferritin levels were negatively correlated with the prognosis survival of patients with invasive B-cell lymphoma(r=-0.718,-0.823,-0.753,P<0.05).Conclusion Levels of serum LDH,β_(2)-MG,and ferritin are negatively correlated with the prognosis survival of patients with invasive B-cell lymphoma,which helps to objectively evaluate the prognosis of patients in clinical practice.