淋巴细胞单核细胞比值对原发胃肠弥漫大B细胞淋巴瘤患者的临床特征和预后影响

Effect of Lymphocyte/Monocyte Ratio on Clinical Features and Prognosis of Patients with Primary Gastrointestinal Diffuse Large B Cell Lymphoma

目的:探讨淋巴细胞/单核细胞比值(lymphocyte/monocyte ratio,LMR)对原发胃肠弥漫大B细胞淋巴瘤(primary gastrointestinal diffuse large B-cell lymphoma,PGI-DLBCL)临床特征和预后的影响。方法:回顾性研究分析我院收集的具有完整随访资料的38例PGI-DLBCL患者。应用自动化全血细胞计数统计患者初诊时淋巴细胞(ALC)和单核细胞(AMC)数,并计算两者比值(LMR),通过ROC曲线得到LMR cut off值,根据cut off值将38例患者分为≤3.9组和﹥3.9组。结果:PGI-DLBCL患者男性21例,女性17例,中位年龄为55岁(29-73岁);其中死亡7例(18.4%),临床出现B组症状7例(18.4%);病理类型生发中心(germinal center B-cell-like DLBCL,GCB)13例(34.2%);原发胃部18例,肠道20例。LM R与PGI-DLBCL的临床分期和肿物大小有关;本组PGIDLBCL患者的中位生存期为44个月(7-100个月),5年OS为78.3%。单因素生存分析显示,年龄(P=0.021)、分期(P=0.012)、IPI评分(P=0.001)、LDH水平(P﹤0.001)、肿物大小(P=0.037)和LMR(P=0.026)均影响PGI-DLBCL患者5年OS率,差异具有统计学意义;多因素分析显示,临床分期是影响OS的独立危险因素。结论:LM R对PGI-DLBCL的临床特征及预后有重要价值。

Objective：To analyze the effect of lymphocyte/monocyte ratio（LMR） on clinical features and prognosis of patients with primary gastrointestinal diffuse large B cell lymphoma（PGI-DLBCL）.Methods：The clinical data of38 PGI-DLBCL patients with complete follow-up data in our hospital were analyzed retrospectively.The absolute lymphocyte count（ALC）,absolute monocyte count（AMC） and LMR were counted by automating complete blood cell count statistics in newly diagnosed patients,and then the LMR cut off value was obtained by ROC curve.All patients were divided into ≤3.9 group and 〉 3.9 group according to cut off value.Results：Out of 38 patients 21 male and 17 female with a median age 55 old years（29-73 years）,7 cases died,the clinical B symptom occurred in 7 cases（18.4%）;the pathologic type of 13 cases（34.2%） belonged to germinal center B-cell like,the primary gastral and intestinal DLBCL were observed in 18 and 20 cases respectively.The chisquare test showed that the LMR associated with of clinical stage and tumor size of PGI-DLBCL.The median survival time was 44 months（7-100 months）,and 5-year overrall survival（OS） rate was 78.3%for 38 PGI-DLBCL cases.The univariate analysis showed that age（P=0.021）,stage（P= 0.012）,IPI score（P= 0.001）,LDH level（P〈0.001）,tumor size（P= 0.037） and LMR（P=0.026） all associate with the 5 years OS rate（%）,and the difference was between them statistically significant,but the multivariate analysis showed that only clinical staging is independent risk factors for the OS.Conclusion：LMR shows an important effect on clinical features and prognosis of PGI-DLBCL.