LMR和LMR/LDH对原发韦氏环弥漫大B 细胞淋巴瘤预后的影响

Influence of LMR and LMR/LDH on Prognosis of Primary Waldeyer’s Ring Diffuse Large B-cell Lymphoma

目的探讨外周血LMR和LMR/LDH在原发韦氏环弥漫性大B细胞淋巴瘤(DLBCL)患者预后中的预测价值。方法收集71例原发韦氏环DLBCL患者临床资料,采用ROC曲线确定患者治疗前外周血LMR、LMR/LDH的最佳临界值,卡方检验分析LMR高低组和LMR/LDH高低组构成比和率。生存率的比较采用Kaplan-Meier法,单因素分析用Log rank法检验,多因素分析用Cox风险回归模型。结果 LMR和LMR/LDH临界值分别为2.97和1.56。高LMR组患者的预后明显优于低LMR组(P<0.001);高LMR/LDH组患者的预后明显优于低LMR/LDH组(P<0.001)。单因素分析显示年龄、B症状、临床分期、治疗疗效、IPI评分、LDH水平、LMR及LMR/LDH是影响早期韦氏环DLBCL患者预后的重要因素;多因素分析显示LMR/LDH、年龄、临床分期是其独立预后因素。结论 治疗前LMR和LMR/LDH在韦氏环DLBCL患者预后中可能具有一定的预测价值。

Objective To investigate the predictive value of peripheral blood LMR and LMR/LDH on the prognosis of primary Waldeyer’s Ring DLBCL patients.Methods We collected 71 patients with primary Waldeyer’s Ring DLBCL.The ROC curve was used to determine the optimal critical values of LMR and LMR/LDH before treatment.The chi-square test was used to analyze the constituent ratio and rate of high and low LMR groups as well as high and low LMR/LDH groups.Kaplan-Meier method was used to calculate survival rate.Log rank method and Cox risk regression model were used for univariate and multivariate analyses,respectively.Results The optimal critical values of LMR and LMR/LDH were 2.97 and 1.56,respectively.The prognosis of patients in the high LMR group was significantly better than that in the low LMR group (P<0.001).The prognosis of patients in the high LMR/LDH group was significantly better than that in the low LMR/LDH group (P<0.001).Univariate analysis showed that age,B symptoms,clinical stage,treatment efficacy,IPI score,LDH level,LMR and LMR/LDH were important factors that influenced the prognosis of early-stage Waldeyer’s Ring DLBCL.Multivariate analysis showed that the age,clinical stage and LMR/LDH were independent prognostic factors.Conclusion LMR and LMR/LDH before treatment may have certain value in predicting the prognosis of Waldeyer’s Ring DLBCL patients.