弥漫大B细胞淋巴瘤中血清铁蛋白的临床意义

Clinical significance of serum ferritin in diffuse large B cell lymphoma

目的探讨弥漫大B细胞淋巴瘤(DLBCL)中血清铁蛋白(SF)的临床意义。方法回顾性分析2015年7月1日至2017年7月1日郑州大学第一附属医院初治且病例资料完整的50例DLBCL患者的病例资料,用多重线性回归方法分析临床指标对SF的影响,由ROC曲线获得SF临界值。通过χ~2检验分析SF临界值在临床分期、预后分级及治疗前后中比值的差异。结果临床分期是SF的影响因素,通过ROC曲线求得SF的临界值为424 ng/ml。Ann Arbor分期研究显示:Ⅲ~Ⅳ期中SF>424 ng/ml的患者比例为56.25%,高于Ⅰ~Ⅱ期的11.11%,差异有统计学意义(χ~2=9.780,P<0.05);通过国际预后指数(IPI)所进行的预后分级研究显示:高中危组和高危组中SF>424 ng/ml的患者比例为54.84%,高于低危组和低中危组的15.79%,差异有统计学意义(χ~2=7.484,P<0.05)。初治效果比较:SF≤424 ng/ml患者的缓解率为80.00%,高于SF>424 ng/ml患者的30.00%,差异有统计学意义(χ~2=12.500,P<0.05)。结论 SF的临界值424 ng/ml在DLBCL的临床分期、预后分级及治疗效果预测中具有重要意义。

Objective To investigate the clinical significance of serum ferritin （SF） in diffuse large B cell lymphoma（ DLBCL ）. Methods The data of 50 patients with DLBCL who were initially treated and had complete case data in the First Affiliated Hospital of Zhengzhou University from 1st July 2015 to 1st July 2017 were retrospectively analyzed. The effects of clinical parameters on SF were analyzed by multiple linear regression and the critical value of SF was obtained by ROC curve. The differences of SF threshold in clinical stage, prognosis grade and before and after treatment were analyzed by χ 2 test. Results The clinical stage is the influencing factor of SF, and the critical value of SF was 424 ng/ml by ROC curve. Ann Arbor staging showed that the proportion of patients with SF〉424 ng/ml in stage Ⅲ～Ⅳ was 56.25%, which was 11.11% of the patients in stage Ⅰ～ Ⅱ , there was statistical significance （ χ^2=9.780, P 〈0.05 ）. The classification of prognosis by international prognostic index （IPI） showed that the proportion of patients with SF〉 424 ng/ml in high-risk group and high-risk group was 54.84%, which was 15.79% of the patients in low-risk group and low-risk group, there was statistical significance （ χ ^2=7.484, P 〈0.05 ）. Comparison of initial treatment results, the remission rate of patients with SF≤424 ng/ml was higher than that of patients with SF〉424 ng/ml , the difference was statistically significant （ χ ^2= 12.500, P 〈0.05 ）. Conclusion The critical value of SF 424 ng/ml is of great significance in the clinical stage of DLBCL, prognosis grading and treatment effect.