结外NK/T细胞淋巴瘤患者治疗前红细胞分布宽度与预后的关系研究

Study on the relationship between red blood cell distribution width and prognosis of patients with extranodal NK/T cell lymphoma before treatment

目的探讨结外NK/T细胞淋巴瘤(ENKTL)患者治疗前红细胞分布宽度(RDW)与预后的关系。方法选取该院收治的ENKTL患者191例进行回顾性分析,收集患者的临床资料、实验室指标,并进行随访,采用受试者工作特征曲线(ROC曲线)计算治疗前RDW预测ENKTL患者预后的截断值为46.2,根据截断值将患者分为低RDW组(107例)和高RDW组(84例),比较两组的临床特征、治疗方案、治疗效果;分析影响ENKTL患者预后的危险因素;分析RDW及C反应蛋白(CRP)水平对患者生存率的影响。结果低RDW组和高RDW组治疗方案与治疗效果比较,差异无统计学意义(P>0.05)。多因素分析结果显示,RDW>46.2及CRP>5.63 mg/L是ENKTL患者不良预后的独立危险因素(P<0.05)。高RDW组3年、5年生存率分别为65.5%、39.8%,低于低RDW组的83.2%、70.7%(P<0.05);高CRP组(CRP>5.63 mg/L)3年、5年生存率分别为54.7%、32.6%,低于低CRP组(CRP≤5.63 mg/L)的78.2%、66.5%(P<0.05)。结论治疗前RDW、CRP水平升高是影响ENKTL患者不良预后的独立危险因素,可通过检测患者RDW、CRP水平变化来评估其预后,指导临床治疗。

Objective To explore the relationship between the red blood cell distribution width(RDW)and prognosis of patients with extranodal NK/T cell lymphoma(ENKTL)before treatment.Methods Selected 191 ENKTL patients admitted to the hospital for retrospective analysis,collected patients′clinical data,laboratory indicators,and follow-up.The receiver operating characteristic curve(ROC curve)was used to calculate the cutoff value of RDW before treatment to predict the prognosis of ENKTL patients,which was 46.2.According to the cutoff value,the patients were divided into low RDW group(107 cases)and high RDW group(84 cases).Compared the clinical characteristics,treatment plan and treatment effect between the two groups.Analyzed the risk factors affecting the prognosis of ENKTL patients.Analyzed the effects of RDW and C-reactive protein(CRP)levels on the survival rate of patients.Results There was no statistically significant difference in the treatment plan and the treatment effect between the low RDW group and the high RDW group(P>0.05).Multivariate analysis showed that RDW>46.2 and CRP>5.63 mg/L were independent risk factors for the adverse prognosis of ENKTL patients(P<0.05).The 3-year and 5-year survival rates of the high RDW group were 65.5%and 39.8%respectively,which were lower than 83.2%and 70.7%of the low RDW group(P<0.05).The 3-year and 5-year survival rates of high CRP group(CRP>5.63 mg/L)were 54.7%and 32.6%respectively,which were lower than 78.2%and 66.5%of the low CRP group(CRP≤5.63 mg/L)(P<0.05).Conclusion The increase of RDW and CRP levels before treatment are independent risk factors affecting the adverse prognosis of ENKTL patients.The prognosis of patients can be evaluated by detecting the changes of RDW and CRP levels,and guiding clinical treatment.