DLBCL患者CHOP或R-CHOP化疗前后中性粒细/淋巴细胞比值的变化及其对生存的影响

Change of Neutrophils/Lymphocyte Ratio in Patients with DLBCL before and after CHOP or R-CHOP Chemotherapy and Its Effect on Survival of Patients

目的:分析弥漫大B细胞淋巴瘤(DLBCL)患者CHOP或R-CHOP方案化疗前后外周血中性粒细胞/淋巴细胞比值(NLR)变化及其对患者生存情况的影响。方法:收集本院60例DLBCL患者的临床资料进行回顾性分析,按照患者NLR中位数的水平将其分为L组33例(NLR<2.27)和H组27例(NLR≥2.27),比较两组行CHOP或R-CHOP方案化疗后的疗效及生存情况。结果:H组化疗后治疗总有效率(55.56%)明显低于L组(87.88%),且差异具有统计学意义(P<0.05);H组化疗后1、2、3年累积生存率(70.37%、59.26%、37.04%)均明显低于L组(93.94%、87.88%、60.61%)(P<0.05)。化疗前外周血NLR≥2.27是DLBCL患者预后的影响因素(P<0.05)。结论:本组化疗前NLR≥2.27可能是DLBCL患者预后的影响因素,其水平偏高可能提示临床疗效欠佳,预后也较差。

Objective： To analyze the change of neutrophil/lymphocyte ratio（ NLR） in patients with diffuse large B cell lymphoma（ DLBCL） patients before and after CHOP or R-CHOP chemotherapy and its effect on survival of patients. Methods： Clinical data of 60 patients with DLBCL were collected and were retrospectively analyzed.According to median NLR,60 patients were divided into the group L in 33 cases（ NLR〈 2. 27） and group H in 27 cases（ NLR ≥ 2. 27）. The curative effect and survival rate by using CHOP or R-CHOP after chemotherapy were compared between the two groups. Results： In the group H,the total effective rate after chemotherapy（ 55. 56%） was significantly lower than that of group L（ 87. 88%）,which showed that the difference were statistically significant（ P〈0. 05）; the cumulative survival rate of 1,2,3 years in the group H（ 70. 37%,59. 26%,37. 04%） were significantly lower than that in the group L（ 93. 94%,87. 88%,60. 61%）（ P〈0. 05）. The NLR≥ 2. 27 before chemotherapy was the factor influencing the prognosis of patients with DLBCL（ P〈0. 05）. Conclusion： The NLR ≥ 2. 27 before chemotherapy may be used as a factor influencing the prognosis of patients with DLBCL,and the high NLR may indicate poor clinical efficacy and worse prognosis.