原发性中枢神经系统淋巴瘤患者预后的影响因素分析

Analysis of prognostic factors in patients with primary central nervous system lymphoma

目的探讨原发性中枢神经系统淋巴瘤(PCNSL)患者预后的影响因素。方法收集82例PCNSL患者的临床资料,包括性别、年龄、病灶数量、病灶部位、病灶直径、治疗方法、意识状态、体力状况(PS)评分等一般资料,以及脑脊液(CSF)常规检测指标(CSF蛋白质、CSF氯化物)和生化检测指标[血清乳酸脱氢酶(LDH)、β2微球蛋白(β2-MG)]等实验室检查资料。对所有患者进行2年随访,采用多因素Cox回归模型分析PCNSL患者预后的影响因素。结果单因素分析结果显示,年龄﹤60岁、意识正常、PS评分﹤1分的PCNSL患者的2年生存率分别高于年龄≥60岁、意识障碍、PS评分≥1分的患者,差异均有统计学意义(P﹤0.05)。Cox多因素分析结果显示,年龄≥60岁、意识障碍均是PCNSL患者预后的独立危险因素(P﹤0.05)。结论年龄和意识状态均是PCNSL患者预后的独立影响因素,年龄越大、意识状态越差,患者的预后越差。

Objective To explore the prognostic factors in patients with primary central nervous system lymphoma(PCNSL).Method The clinical data of 82 patients with PCNSL,including gender,age,number of lesions,location,size,treatment methods,consciousness status,performance status(PS)scores,cerebrospinal fluid(CSF)protein,CSF-chloride,serum lactate dehydrogenase(LDH)andβ2-microglobulin(β2-MG)were collected.The patients were followed-up for 2 years and the multivariate Cox regression analysis was used to analyze the prognostic factors of PCNSL.Result Univariate analysis showed that the 2-year survival rate of PCNSL patients with age<65 years,normal consciousness,PS score<1 were significantly higher than patients with age≥60 years,consciousness disorder,PS score≥1,the differences were statistically significant(P<0.05).Multivariate Cox regression analysis showed that age≥60 years,consciousness disorder were independent risk factors for the prognosis of patients with PCNSL(P<0.05).Conclusion Age and consciousness status are independent factors affecting the prognosis of PCNSL patients,with worse prognosis for patients with older ages or worse consciousness status.