鼻腔NK/T细胞淋巴瘤患者的临床病理特征和预后因素分析

Clinical features,haematological index and prognostic factor analysis in patients with nasal cavity NK / T-cell lymphoma

目的探讨鼻腔NK/T细胞淋巴瘤的临床病理特征及其预后影响因素。方法选择2010年8月至2014年10月就诊的鼻腔NK/T细胞淋巴瘤患者60例作为研究对象。根据患者治疗方法的不同分为观察A组和观察B组,观察A组32例,观察B组28例,其中观察A组患者给予调强根治性放疗技术或三维适形,观察B组患者给予CHOP(环磷酰胺+长春新碱+泼尼松+阿霉素)或DICE(地塞米松+异环磷酰胺+顺铂+依托泊甙)方案为主的诱导化疗。结果观察A组患者总有效率为81.3%,观察B组患者总有效率为82.1%,组间差异无统计学意义(P>0.05)。单因素分析结果显示,Ann Arbor分期、国际预后指数(IPI)评分、身体状况(PS)评分、乳酸脱氢酶(LDH)、球蛋白、白细胞和β2-微球蛋白与预后有关。多因素分析结果显示,LDH水平、首次治疗达到完全缓解(CR)和治疗模式为影响鼻腔NK/T细胞淋巴瘤预后的独立因素。结论 LDH水平、首次治疗达到CR以及治疗模式为影响鼻腔NK/T细胞淋巴瘤预后的参考指标,有助于指导临床工作。

Objective To explore the clinical features,haematological index and prognostic factor analysis in patients with nasal cavity natural killer cell（ NK） / T-cell lymphoma. Methods Totally 60 patients with nasal cavity NK / T-cell lymphoma in The Second People＇s Hospital of Panzhihua City were selected. The patients were divided into Group A and Group B according to different therapies. Clinical data,pathological features,haematological index and prognostic factors of patients were analyzed. Results The total effective rate of Group A and Group B was 81. 3% and 82. 1% respectively,with significant difference（ P 0. 05）; According to single-factor analysis,Ann Arbor staging,international prognostic index（ IPI）scores,performance status（ PS） scores,lactate dehydrogenase（ LDH）,globulin,leukocyte,β2-microglobulin were correlated with prognosis; According to multiple-factor analysis,LDH,complete response（ CR） after initial treatment and treatment mode were the independent factors for prognosis of nasal cavity NK / T-cell lymphoma. Conclusion LDH,CR after initial treatment and treatment mode were the reference index for prognosis of nasal cavity NK / T-cell lymphoma,which help to guide the clinical work.