弥漫性大B细胞淋巴瘤的临床特征及相关因素分析

Clinical characteristics and prognosis of diffuse large B-cell lymphoma

目的探讨弥漫性大B细胞淋巴瘤(diffuse large B cell lymphoma,DLBCL)临床特征与预后相关因素的关系。方法回顾性分析72例DLBCL患者的临床资料及随访结果,分析国际预后指数(international prognostic index,IPI)和血清血管内皮生长因子(vascular endothelial growth factor,VEGF)水平及随访结果。结果72例中男女比例为2.6:1,平均年龄67岁,累及淋巴结52例(72.2%),结外以胃肠道和扁桃体最为多见。全部病例随访时间最长达108个月,死亡50例(69.4%),其中16例在诊断后1年内死亡(22.2%)。IPI分组与预后明显相关,IPI低者预后明显好于IPI高者(P=0.041),血清VEGF水平高的患者预后明显低于血清VEGF水平低者,差异有统计学意义。结论DLBCL属高度侵袭性肿瘤,IPI和VEGF水平可以用于DLBCL预后判断。

Objective To study the clinical characteristics of diffuse large B-cell lymphoma （DLBCL） and its correlated factors in prognosis. Methods International prognostic index （IPI）, vascular endothelial growth factor （VEGF） and the follow-up results of 72 patients with DLBCL were analyzed retrospectively. Results The ratio of male to female was 2.6 and the average age was 67. Lymph node were involved in 52 （72.2%） cases and gastric intestinal tract and tonsil were the most common extranodal sites of involvement. The longest survival period lasted 108 months. There were 50 patients （69.4%） died during follow-up while 16 cases died in the first year after diagnosis （ 16/72,22.2% ）. IPI was an independent prognostic index. Prognosis was better in cases with low IPI index than those with high index （P =0. 041 ）. The survival rates were correlated significantly with serum VEGF. Conclusion DLBCL is of highly aggressive tumor. IPI and serum VEGF can be used to predict the clinical outcome.