HBV与LDH对弥漫性大B细胞淋巴瘤患者化学治疗效果的影响——附144例报告

Effect of HBV / LDH on clinical efficacy of chemotherapy in treatment of diffuse large B cell lymphoma:report of 144 cases

目的探讨HBV与乳酸脱氢酶（LDH）对弥漫性大B细胞淋巴瘤（DLBCL）患者化学治疗效果的影响。方法以144例初治DLBCL患者为研究对象,其中HBsAg（＋）66例,LDHdt（LDH水平正常为N、高于正常为H）77例。将其分别按血清HBsAg是否（＋）、LDH水平是否正常分为4组：HBsAg（-）/LDH-N组45例,HBsAg（-）/LDH-H组33例,HBsAg（＋）/LDH-N组22例,HBsAg（＋）/LDH-H组44例。所有患者采用CHOP方案治疗4~6个疗程,分析HBV、LDH对化学治疗总有效率的影响。结果 HBsAg（＋）者化学治疗总有效率为62.1%（41/66）;HBsAg（-）者化学治疗总有效率为82.1%（64/78）,HBsAg（-）者总有效率高于HBsAg（＋）者（P〈0.01）。LDH-H者化学治疗总有效率为64.9%（50/77）;LDH-N者化学治疗总有效率为82.1%（55/67）,LDH-N者总有效率高于LDH-H者（P〈0.05）。分组结果显示：①HBsAg（-）/LDH-N组治疗总有效率为84.4%（38/45）;②HBsAg（-）/LDH-H组治疗总有效率为78.8%（26/33）;③HBsAg（＋）/LDH-N组治疗总有效率为77.3%（17/22）;④HBsAg（＋）/LDHdt组治疗总有效率为54.5%（24/44）,4组总有效率比较差异有统计学意义（P=0.01）。4组总有效率的两两比较结果显示HBsAg（-）/LDH-N组总有效率高于HBsAg（＋）/LDH-H组（P=0.002）,其余各组的两两比较结果尚未有统计学意义。结论感染HBV与高LDH可能对DLBCL的化学治疗效果有负面影响.两者可能起协同作用。

Objective To evaluate the effect of hepatitis B virus（HBV） and lactate dehydrogenase（LDH） upon the clinical efficacy- of chemotherapy in the treatment of diffuse large B cell lymphoma（DLBCL）.Methods In total,144 patients with DLBCL who were treated for the first time were recruited in this study.Among them,66 cases were found to be HBsAg（＋） and 77 with high level of LDH（LDH-H）.According to HBsAg status（positive/negative） and LDH level（high/nomml）,all participants were divided into the HBsAg（-） /LDH-N（n=45）,HBsAg（-） /LDH-H（n=33）,HBsAg（＋） /LDH-N（n=22） and HBsAg（＋） /LDH-H groups（n = 44）.All patients received 4-6 cycles of CHOP regime.The effect of HBV and LDH upon the overall efficacy of chemotherapy was assessed.Results The overall efficacious rate of chemotherapy in DLBCL patients with HBsAg（＋） was 62.1%（41/66）,significantly lower compared with 82.1%（64/78） of those with HBsAg（-）.The overall efficacious rate of chemotherapy in DLBCL patients with LDH-H was 64.9%（50/77）,considerably lower than 82.1%（55/67） of their counterparts with LDH-N（P 0.05）.Group comparison revealed that overall efficacious rate of chemotherapy in the HBsAg（-） /LDHN group was 84.4%（38/45）,78.8%（26/33） in the HBsAg（-） /LDH-H group,77.3%（17/22） in the HBsAg（＋） /LDH-N group and 54.5%（24/44） in the HBsAg（＋） /LDH-H group with statistical significance among four groups（P = 0.01）.Paired comparison indicated that overall efficacious rate in the HBsAg（-） /LDH-N group was significantly higher than that in the HBsAg（＋） /LDH-H group（P =0.002）.No statistical significance was noted among the other groups.Conclusion hffection of HBV and high level of LDH probably exert a negative and synergetic effect upon the clinical efficacy of chemotherapy in treating DLBCL.