淋巴细胞计数对弥漫大B细胞淋巴瘤的预后价值分析

Value of absolute lymphocyte count in prognosis of diffuse large B cell lymphoma

目的探讨外周血淋巴细胞绝对数（ALC）与初发弥漫大B细胞淋巴瘤（DLBCL）患者预后的关系.方法回顾性分析71例DLBCL患者的临床特征,比较初发时ALC不同的患者之间临床特点及转归.结果71例患者中,ALC〉1×109/L者27例（38.0%）,ALC≤1×109/L者44例（62.0%）.ALC不同的两组患者间,年龄、性别、临床分期、B症状等临床特征均无统计学差异（均P〉0.05）.ALC低者Hb平均值更低,淋巴细胞亚群中T辅助细胞、NK细胞百分比更低,总T细胞、T抑制细胞百分比更高（均P〈0.05）.共同接受CHOP方案治疗条件下,初诊时ALC低者临床缓解率相对较低,病死率较高,中位生存期更短,总生存率更低（均P〈0.05）.结论 ALC减少可能成为DLBCL患者预后的重要指标.

Objective To assess the prognostic value of peripheral blood absolute lymphocyte count （ALC） at admission for patients with diffuse large B cel lymphoma （DLBCL）. Methods The association of absolute number of peripheral blood lym-phocytes at admission with the clinical features and prognosis of 71 DLBCL patients was retrospectively analyzed. Results A-mong 71 DLBCL patients 27 cases （38.0%） had high ALC level （〉1×109/L） and 44 （62.0%） had low ALC level （≤1×109/L） at admission. There was no significant differences in age,gender,clinical stage and B symptoms between two groups,while pa-tients with lower ALC had lower hemoglobin level, lower percentage of Th cell and NK cel s, higher percentage of T cel s and Ts cel s（P〈0.05）. After chemotherapy patients with lower ALC had lower incidence of complete remission （CR）, higher mortality rate （P〈0.05）, shorter median survival time and a lower overal survival （P〈0.05）. Conclusion Data suggest that absolute lympho-cyte count at admission is a valuable prognostic indicator for patients with diffuse large cel lymphoma.