老年营养风险指数在弥漫大B细胞淋巴瘤患者中的预后意义

Prognostic value of geriatric nutritional risk index in diffuse large B cell lymphoma

目的:探讨老年营养风险指数(GNRI)在非特指型弥漫大B细胞淋巴瘤(DLBCL)患者中的预后价值。方法:回顾性收集249例非特指型初治的DLBCL患者,结合患者的基本临床特征及生存进行相关性分析。结果:249例DLBCL患者中,男142例,女107例,中位年龄60(18~85)岁。GNRI<96.6和GNRI≥96.6患者的3年总生存率(OS)和3年无进展生存率(PFS)分别为46.6%vs 67.7%(P=0.000),44.6%vs 61.9%(P=0.001)。接受R-CHOP或R-CHOP样方案治疗且GNRI≥96.6的患者拥有更长的3年OS(53.6%vs 76.3%,P=0.002)和3年PFS(50.2%vs 73.2%,P=0.001)。单因素分析显示低GNRI者拥有更差的OS,但多因素分析显示GNRI并不是DLBCL患者独立的预后因素。GNRI对改良国际预后指数危险分层患者的OS影响差异无统计学意义。结论:低GNRI者拥有更差的预后;GNRI并不是DLBCL患者独立的预后因素。

Objective：To evaluate the prognostic value of geriatric nutritional risk index in patients with not otherwise specified diffuse large B cell lymphoma（DLBCL）.Method：Data of 249 patients diagnosed as de novo DLBCL were analyzed retrospectively.Correlation analysis was done based on patients＇ characteristics and survival.Result：A total of 249 cases[142 cases male and 107 cases female with a median age of 60（18 to 85）years old]were enrolled.Patients with a GNRI〈96.6 had significantly lower overall survival（OS）and progression-free survival（PFS）than those with a GNRI≥96.6（3-year OS 46.6% vs 67.7%,P=0.000;3-year PFS 44.6% vs61.9%,P=0.001）.Patients receiving R-CHOP or R-CHOP like regimens and with GNRI ≥96.6 had longer3 years of OS（53.6% vs 76.3%,P=0.002）and 3 years of PFS（50.2% vs 73.2%,P=0.001）.Univariate analysis showed that patients with low GNRI had poorer OS,but multivariate analysis showed that GNRI was not an independent prognostic factor for DLBCL patients.GNRI had no significant difference in the OS effect of the modified International Prognostic Index for risk stratified patients.Conclusion：Patients with low GNRI have poorer prognosis;GNRI is not an independent prognostic factor for DLBCL patients.