原发鼻腔NK/T细胞淋巴瘤影响预后的因素分析

Prognostic factors of nasal NK/T-cell lymphoma

目的 分析鼻腔NK/T细胞淋巴瘤患者的临床特征及血液学指标,探讨影响预后的因素.方法 回顾性分析天津医科大学附属肿瘤医院80例鼻腔NK/T细胞淋巴瘤患者的临床特征及血液学指标,采用Kaplan-Meier法进行生存分析,Cox模型进行多因素分析.结果 80例患者经过治疗后,33例患者达到完全缓解,5年总生存率和无进展生存率分别为52.5％和32.5％.单因素分析显示,美国东部肿瘤协作组评分（Eastern Cooperative Oncology Group performance status,ECOGPS）、Ann Arbor分期、腔外受累、国际预后指数（international prognostic index,IPI）评分、首次治疗是否达完全缓解、治疗模式（单纯化疗与放化疗联合）、血清乳酸脱氢酶（LDH）和β2-微球蛋白和球蛋白水平、外周血白细胞计数与鼻腔NK/T细胞淋巴瘤患者的预后相关（P值均＜0.05）.多因素分析显示,首次治疗是否达完全缓解、LDH、腔外受累是影响鼻腔NK/T细胞淋巴瘤预后的独立危险因素（x2值分别为17.109、15.695和13.503,P值均＜0.01）.结论 首次治疗是否达完全缓解、LDH、腔外受累可作为鼻腔NK/T细胞淋巴瘤临床预后的参考指标.

Objective To investigate the prognostic predictors of nasal NK/T cell lymphoma. Methods Records of 80 patients with nasal NK/T cell lymphoma were analyzed retrospectively. The correlation between clinical and haematological factors and prognosis was analyzed with univariate and multivariate analysis. Results After treatment, 33 of 80 patients achieved complete response, the 5-year overall survival and progression free survival were 52. 5% and 32. 5% , respectively. In univariate analysis, Eastern Cooperative Oncology Group performance status, Ann Arbor stage, local tumor invasion out of the nasal cavity, international prognostic index, complete response rate to the primary treatment, treatment model, lactate dehydrogenase （LDH）, x^2-microglobulin level, globulin and white blood cell were found to be the prognostic factors. Multivariate analysis indicated that unfavorable prognostic factors included complete response rate to the primary treatment （ x^2 = 17. 109, P 〈 0. 01 ）, LDH （ x^2 = 15. 695, P 〈 0. 01 ）, and local tumor invasion out of the nasal cavity（ x^2 = 13. 503, P 〈 0. 01 ）. Conclusion Complete response rate to the primary treatment, elevated plasma LDH and tumor invasion out of the nasal cavity may be independent prognostic factors for NK/T cell lymphoma.