弥漫性大B细胞淋巴瘤和滤泡性淋巴瘤患者静脉血栓栓塞症的对比分析

Comparative analysis of venous thromboembolism between patients with diffuse large B cell lymphoma and follicular lymphoma

目的比较弥漫性大B细胞淋巴瘤(DLBCL)和滤泡性淋巴瘤(FL)的静脉血栓栓塞(VTE)发病风险,明确VTE发病对DLBCL患者和FL患者预后的影响。方法应用回顾性研究方法,从病历中收集患者资料。对比分析DLBCL和FL两组患者的一般资料、VTE发病和预后指标。应用logistic回归分析淋巴瘤患者VTE发病的危险因素。结果(1)579例DLBCL患者确诊后5年VTE发病94例,VTE 5年发病率16.23%;256例FL患者确诊后5年VTE发病9例,VTE 5年发病率3.52%。两组患者的5年VTE发病率比较差异有统计学意义(P<0.05)。(2)在DLBCL亚组中,94例VTE患者5年生存46例,5年总生存率为48.94%;485例非VTE患者5年生存331例,5年生存率为68.25%;两组患者的5年生存率比较,差异有统计学意义(P<0.05)。在FL亚组中,9例VTE患者5年生存6例,5年生存率为66.67%;247例非VTE患者5年生存203例,5年生存率为82.19%;两组患者的5年生存率比较,差异有统计学意义(P<0.05)。(3)DLBCL、ECOG ps≥2分、既往VTE病史、血清白蛋白低、血清钙浓度高、白细胞高、单核细胞计数高、NLR高、CD10阳性、巨块型瘤体是淋巴瘤患者VTE发病的危险因素(P<0.05)。结论DLBCL患者的VTE发病率高于FL患者;VTE发病和DLBCL患者、FL患者的5年OS具有相关性。

Objective To compare the risks of venous thromboembolism(VTE)between diffuse large B cell lymphoma(DLBCL)and follicular lymphoma(FL),so as to clarify the influence of VTE on the prognosis of patients with DLBCL and FL.Methods A retrospective study was conducted.Patient data were assessed from medical records.The general data,VTE incidence and prognosis indexes of the two groups were compared and analyzed.The logistic regression was used to analyze the risk factors of VTE in lymphoma patients.Results Five years after the diagnosis of 579 patients with DLBCL,94 patients developed VTE,and the 5-year survival rate of VTE was 16.23%.Five years after diagnosis,VTE occurred in 9 of 26 FL patients,and the 5-year survival rate of VTE was 3.52%.The 5-year VTE incidence between the two groups was significantly different(P<0.05).In DLBCL subgroup,46 of 94 VTE patients survived for 5 years,and the 5-year survival rate was 48.94%.Among 45 non-VTE patients,331 survived for 5 years,and the 5-year survival rate was 68.25%.The 5-year survival rate of the two groups was significantly different(P<0.05).In FL subgroup,6 of 9 VTE patients survived for 5 years,and 5 years survival rate was 66.67%.And 203 of 47 non-VTE patients survived for 5 years,and the 5-year survival rate was 82.19%.Comparing the 5-year survival rate between the two groups,the difference was statistically significant(P<0.05).DLBCL,ECOG ps≥2 points,past VTE history,low serum albumin,high serum calcium concentration,high white blood cells,high monocyte count,high NLR,CD10 positive,and massive tumor were the risk factors of VTE in lymphoma patients(P<0.05).Conclusion The incidence of VTE in patients with DLBCL is higher than that in patients with FL.The incidence of VTE is correlated with 5-year survival rate in patients with DLBCL and FL.