1173例淋巴瘤患者死亡原因调查

Causes of death in 1,173 patients with lymphoma

目的:分析淋巴瘤患者人群的死亡原因和长期预后情况。方法:收集北京大学肿瘤医院1995年1月至2017年12月收治的6 200例淋巴瘤患者的基线资料,筛选其中已经发生死亡且死亡原因已知的患者,并收集其临床资料和死亡信息。结果:共筛选出1173例患者,其中男性742例(63.3%),女性431例(36.7%)。中位年龄为56(8~ 92)岁。霍奇金淋巴瘤(Hodgkin's lymphoma,HL) 77例(6.6%),非霍奇金淋巴瘤(non-Hodgkin's lymphoma,NHL) 1095例(93.4%),病理分类不明确1例。总体人群生存期为0~ 253个月,中位生存期为20个月。直接死亡原因包括淋巴瘤688例(58.7%),各类感染性疾病119例(10.1%),心血管疾病(car diovascular disease,CVD) 96例(8.2%),第二原发肿瘤68例(5.8%),其他疾病202例(17.2%)。根本死亡原因包括淋巴瘤936例(79.8%),第二原发肿瘤94例(8.0%), CVD75例(6.4%),呼吸系统疾病32例(2.7%)和其他疾病36例(3.1%)。生存期超过5年的217例患者根本死亡原因为淋巴瘤129例(59.4%),第二原发肿瘤38例(17.5%), CVD35例(16.1%)和其他疾病15例(6.9%)。生存期超过10年的60例患者根本死亡原因为淋巴瘤28例(46.7%),第二原发肿瘤17例(28.3%), CVD7例(11.7%)和其他疾病8例(13.3%)。结论:原发肿瘤仍是淋巴瘤患者死亡的主要原因。第二原发肿瘤和CVD是除原发肿瘤以外最常见的死亡原因,并且随着生存期的延长,二者所致的死亡风险明显增加。

Objective: To understand the causes of death and long-term prognosis of lymphoma patients. Methods: Data from 6 200 patients with lymphoma admitted to the Department of Lymphoma, Peking University Cancer Hospital, from January 1995 to December 2017, were collected. Those who had died and whose causes of death were known were selected. Clinical records and information on death were collected. Results: A total of 1,173 patients were selected, 742 of whom were male (63.3%), and 431 were female (36.7%). The median age was 56 (8-92) years. There were 77 cases (6.6%) of Hodgkin's lymphoma, 1,095 cases (93.4%) of non-Hodgkin's lymphoma, and 1 case of unclear pathological classification. Overall population survival was 0-253 months, with a median survival rate of 20 months. The direct causes of death included lymphoma in 688 (58.7%), various infectious diseases in 119 (10.1%), cardiovascular diseases in 96 (8.2%), secondary primary tumors in 68 (5.8%), and other diseases in 202 cases (17.2%). The underlying causes of death included lymphoma in 936 (79.8%), secondary primary tumors in 94 (8.0%), cardiovascular diseases in 75 (6.4%), respiratory diseases in 32 (2.7%) and other diseases in 36 cases (3.1%). The underlying causes of death in cases wherein survival time exceeded 5 years included lymphoma in 129 (59.4%), secondary primary tumors in 38 (17.5%), cardiovascular diseases in 35 (16.1%), and other diseases in 15 cases (6.9%). The underlying causes of death in cases wherein survival time exceeded 10 years included lymphoma in 28 (46.7%), secondary primary tumors in 17 (28.3%), cardiovascular diseases in 7 (11.7%), and other diseases in 8 cases (13.3%). Conclusions: Primary tumors remain the main cause of death in patients with lymphoma. After primary tumors, secondary primary tumors and cardiovascular diseases are the most common causes of death, and with the prolongation of survival, the risk of death caused by these factors increases significantly.