外周T细胞淋巴瘤血清β2-微球蛋白水平与国际预后指数的关系及预后分析

Relationship between the serum level of 152-microglobin and international prognostic index and the prognostic analysis of patients with peripheral T-cell lymphoma

目的探讨血清β2-微球蛋白（β2-MG）水平与国际预后指数（IPI）的关系，及其对外周T细胞淋巴瘤（PTCL）预后判断的应用价值，为个体化治疗提供依据。方法回顾性分析采用CHOP方案治疗的81例PTCL的临床资料，对β2-MG水平、IPI评分系统与疗效及远期生存的关系进行统计学分析。结果全组81例患者，均接受CHOP方案联合化疗，总有效（RR）率为82．7％，完全缓解（CR）率53．1％。IPI评分低危组、低中危组、中高危组及高危组的RR率分别为95．7％、87．5％、53．8％和20．0％，CR率分别为74．5％、37．5％、15．4％和0，各组间差异均有统计学意义（均P〈0．05）。中位随访时间30个月（2～98个月），中位生存期（MST）31．2个月，总的1、3、5年生存（OS）率分别为83．5％、41．8％和34．7％。低危和低中危组MST目前尚未达到，中高危和高危组MST分别为16、7个月，5年OS率分别为57．3％、55．9％、0和0，差异有统计学意义（P〈0．05）。将IPI评分0～1分和2分合并为低危组，3分、4～5分合并为高危组，进行生存比较，前者MST尚未达到，后者为11个月，5年OS率分别为54．8％和0（P〈0．05）。高危组血清B，MG水平均较低危组明显升高，高危组患者较低危组患者血清β2-MG异常者比例也明显升高（均P〈0．05）。多因素分析结果显示血清β2-MG水平、IPI评分与PTCL的预后密切相关（P〈0．05）。结论血清β2-MG水平可以和IPI评分系统一起用于外周T细胞淋巴瘤患者的预后判断。

Objective To determine the relationship between the serum level of β2-microglobin （ β2-MG） and international prognostic index （IPI） and investigate the role of IPI in predicting the prognosis and making individualized therapy for peripheral T-cell lymphoma （PTCL）. Methods Eighty-one patients with PTCL were treated by standard CHOP regimen. The clinical characteristics, response, long-term survival rates and the relationship between serum level of β2-MG and IPI scores were analyzed retrospectively. Results Eighty-one patients were eligible. All of them were treated by CHOP regimen.The overall response rate （RR） was 82.7 % with 53.1% complete remission （CR） rate. The RR of IPI low risk, low-intermediate risk, high-intermediate risk,and high risk were 95.7 %, 87.5 %, 53.8 % and 20.0 %, with CR rate 74.5 %, 37.5 %, 15.4 % and 0, respectively （P 〈0.05）. The median survival times （MST） were 31.2 months at a median follow-up of 30 months （2-98 months）. The actnrial 1-, 3-, and 5-year overall survival （OS） rates were 83.5 %, 41.8 % and 34.7 %, respectively. The 5-year OS rates of low risk, low-intermediate risk, high-intermediate risk, high risk were 57.3 %, 55.9 %, 0 and 0, respectively （P 〈0.05）. The OS rates of low risk group （IPI 0-2 scores） and high risk group （IPI 3-5 scores） were 54.8 % and 0, respective｜y （P 〈0.05）. Serum levels of β2-MG were significantly elevated in the high risk group than those in the low risk group. The proportion of abnormal serum level of β2-MG were also significantly elevated in the high risk group than those in the low risk group.The results of muhivariante analysis showed that serum level of β2-MG and IPI scores were independent progn, ostic factors for PTCL （P 〈0.05）. Conclusion The serum level of β2-MG with IPI scores system can be used for evaluating the prognosis of PTCL patients.