T细胞性非霍奇金淋巴瘤103例的预后分析

A survival analysis of 103 cases of T-cell non-Hodgkin lymphoma

目的 T 细胞性非霍奇金淋巴瘤(T-NHL)是一组异质性疾病,恶性度高,疗效差,在我国相对高发,目前尚无有效的预后指标可以用来预见其治疗效果。本研究回顾性分析103例 T-NHL的临床特征与预后的关系。方法收集1998年12月至2004年12月在中山大学肿瘤防治中心确诊、有完整临床资料的 T-NHL,所有病例按照 WHO 2001淋巴瘤分类标准进行病理分型,并对临床资料进行分析,总结其与预后的关系。结果 103例患者中位年龄35(2～78)岁,男68例,女35例,中位生存时间24.1(0.8～84)个月,5年总生存率24.3%(25/103),其中25例(24.3%)采用放、化联合治疗,70例(68.0%)采用单纯化疗,3例采用单纯放疗,5例在获得完全缓解后进行造血干细胞移植。单因素生存分析年龄≥60岁、晚期病例(Ⅲ、Ⅳ)、结外侵犯、巨大包块、B 症状、体质状况(PS)≥2,LDH 升高、低白蛋白血症、高危国际预后指数(IPI)(IPI≥2)与预后不良有关,但是多因素分析证实年龄≥60岁、低蛋白血症、PS≥2是独立的预后不良因素。结论本研究证实了年龄、血清白蛋白水平、PS 是 T-NHL 的独立预后因素。

Objective T-cell non-Hodgkin lymphoma was heterogeneous and relatively high incident in our country. It＇s response and prognosis were poor. This study was to analyze clinical feature and survival of T-NHL. Methods Records of 103 cases with T-NHL, treated from Dec 1998 to Dec 2004 in Cancer Center of Sun Yat-sen University, were retrospectively analyzed. All the patients were classified according to WHO 2001 Classification Criteria. Results Median age of the whole group was 35 （ ranged 2-78 ） years-old. Of the 103 cases, 68 were male, 35 were female; 25 （24.3%） received chemoradiotherapy, 70 （68.0%） received chemotherapy alone, 3 received radiotherapy and 5 received stem cell transplantation after complete remission. Median survival was 24. 1 （ ranged 0. 8 - 84） months. 5-year survival rate was 24. 3 %. Kaplan-Meier analysis discovered that age ≥60 years, advanced stage （stage Ⅲ, Ⅳ）, extranodal involvement, bulky disease, B symptom, performance status （PS） ≥ 2, LDH elevated, hypoalbumine ,median-high IPI （ IPI ≥ 2 ） were bad to prognosis, but Cox regression found that age ≥ 60 years, performance status （PS） ≥ 2S, hypoalbumine were the independent bad factors to prognosis. Conclusion This study proved that age, albumin, PS were the independent factors to prognosis.