疗前血清Hb水平在早期结外鼻型NK／T细胞淋巴瘤中的预后价值

Prognostic value of pretreatment serum hemoglobin level in early-stage extranodal nasal-type NK/T- cell lymphoma

目的 探讨治疗前血清Hb水平对早期结外鼻型NK/T细胞淋巴瘤预后的影响。 方法 回顾分析2000—2015年间收治的 175例Ⅰ、Ⅱ期结外鼻型NK/T细胞淋巴瘤。纳入标准为原发病灶位于上消化呼吸道,不合并其他恶性疾病,治疗及随访记录完整病例纳入分析。接受单纯化疗 67例、单纯放疗 8例、放化疗 100例。Kaplan-Meier法计算生存率,Logrank法单因素分析,Cox模型多因素分析。 结果 175例患者的变量单因素分析显示疗前血清Hb水平（≥120 g/L）、LDH水平（正常）、ECOG评分（0~1）、Ann Arbor分期（ⅠE）、接受放疗显著提高PFS及OS （P=0.000~0.046）。多因素分析显示血清Hb水平、LDH水平、ECOG评分、Ann Arbor分期是患者PFS、OS影响因素（P=0.000~0.040）。 结论 疗前Hb≥120 g/L者预后好于〈120 g/L者。

Objective To investigate the effect of pretreatment serum hemoglobin （Hb） level on the prognosis of early-stage extranodal nasal-type NK/T-cell lymphoma. Methods A retrospective analysis was performed on the clinical data of 175 patients with stage Ⅰ or Ⅱ extranodal nasal-type NK/T-cell lymphoma who were admitted to The Tumor Hospital Affiliated to Shanxi Medical University from 2000 to 2015. The inclusion criteria included Ann Arbor Ⅰ/Ⅱ stage, the primary tumor located in the upper aerodigestive tract, without other malignant diseases, and complete clinical information and follow-up data. Of the 175 patients, 67 received chemotherapy alone, 8 received radiotherapy alone,100 received radiotherapy and chemotherapyed. The survival rate was calculated using the Kaplan-Meier method. The log-rank test was used for univariate prognostic analysis. The Cox regression model was used for multivariate prognostic analysis. Results The univariate analysis showed that pretreatment serum Hb level （≥120 g/L）, lactate dehydrogenase （LDH） level （normal）, Eastern Cooperative Oncology Group （ECOG） score （0-1）, Ann Arbor stage （IE）, and radiotherapy were associated with significantly improved progression-free survival （PFS） and overall survival （OS）（P=0.000-0.046）. The multivariate analysis showed that pretreatment serum Hb level, LDH level, ECOG score, and Ann Arbor stage were independent prognostic factors for PFS and OS （P=0.000-0.040）. Conclusion Patients with a high pretreatment serum Hb level （≥120 g/L） have a better prognosis than those with a low pretreatment serum Hb level （〈120 g/L）.