霍奇金淋巴瘤121例临床预后因素分析

Clinical and prognostic factors analysis in 121 cases of Hodgkin's lymphoma

目的探讨霍奇金淋巴瘤患者临床指标与预后的关系。方法选择1985年1月￣1999年1月该院治疗的霍奇金淋巴瘤病人共121例,应用SPSS11.5软件行生存分析并对各临床指标与预后的关系进行单因素和COX多因素分析。结果121例霍奇金淋巴瘤患者2年总生存率为74.32%,5年总生存率为55.48%。log-rank单因素分析显示病理组织学分型、缓解情况、B症状、LDH增高、临床分期、病灶的单多发情况、伴发肝脾肿大、血象变化(红细胞压积、白细胞水平)都与生存情况密切相关。而年龄、性别、PS状态、治疗方法、肿瘤大小与总生存期无关。Cox模型多因素分析显示病理组织学分型、缓解情况、是否有B症状、与总生存期有关。结论病理组织学分型、缓解情况、是否有B症状是霍奇金淋巴瘤的独立预后危险因素,淋巴细胞消减型霍奇金淋巴瘤其病情进程快、疗效及预后差。

[Objective]The purpose of this study was to discuss the relationship between clinical data and the prognostic factors of Hodgkin′s lymphoma. From January 1985 to January 1999, 121 cases with Hodgkin′s lymphoma were included. All these patients were treated in our wards of Xiangya hospital of Centre South University. The relationship between clinical data and prognosis were analyzed by SPSS 11.5. The 2-year and 5-year survival rate of these 121 Hodgkin′s lymphoma patients were 74.32% and 55.48% respectively. Log-rank univariate analysis showed that pathohisological type, remission, B symptom, serum lactate dehydrogenase(LDH) level, clinical staging, single or multiple lesions, intumesce of liver and/or spleen, change of hemogram (hematocrit and leucocyte level) were closely associated with survival (P<0.05); while age, gender, performance status, therapy modality tumer size were not associated with overall survival. Cox model multivariate analysis indicated that only Pathohisological type, remission, B symptom were closely associated with overall survival. [Conclusion] pathohisological type, remission, B symptom were the independent prognosic risk factors for Hodgkin′s lymphoma. Lymphocytic depletion Hodgkin′s lymphoma was characterized by short clinical course, poor respose and prognosis.