外周血红蛋白/红细胞分布宽度比值对弥漫大B细胞淋巴瘤患者预后的影响

Influence of the Ratio of Peripheral Hemoglobin-to-Red Cell Distribution width on the Prognosis of Patients with Diffuse Large B-cell Lymphoma

目的:探讨外周血红蛋白/红细胞分布宽度比值(HRR)对弥漫大B细胞淋巴瘤(DLBCL)患者预后的影响。方法:回顾性分析2014年1月至2019年12月徐州医科大学附属医院收治的265例初诊DLBCL患者的临床资料,以同期132名健康体检者作为正常对照。采用受试者工作特征(ROC)曲线确定HRR最佳截断值;应用卡方检验分析HRR与DLBCL患者临床特征的相关性;采用Kaplan-Meier法比较不同分组HRR患者的总生存(OS)率和无进展生存(PFS)率;采用Cox比例风险模型进行单因素、多因素分析。结果:HRR最佳截断值为0.936,以此为界分为低HRR组(<0.936)和高HRR组(≥0.936)。低HRR组患者ECOG评分较高、Ann Arbor分期较晚、LDH水平高于正常值、NCCN-IPI评分较高。K-M生存分析显示,低HRR组的OS(P<0.001)和PFS(P<0.001)时间均较高HRR组显著缩短。多因素Cox分析结果显示,HRR是影响DLBCL患者OS(HR=0.377,95%CI:0.236-0.603,P<0.001)和PFS(HR=0.383,95%CI:0.240-0.612,P<0.001)的独立危险因素。结论:初诊DLBCL患者低HRR(<0.936)提示预后不良,是影响预后的独立危险因素。

Objective:To investigate the influence of peripheral hemoglobin(Hb)-to-red cell distribution width(RDW)ratio(HRR)on the prognosis of patients with diffuse large B-cell lymphoma(DLBCL).Methods:Data of 265 patients with diffuse large B-cell lymphoma(DLBCL)at the Affiliated Hospital of Xuzhou Medical University from January 2014 to December 2019 were retrospectively analyzed.132 healthy people in the same period were used as normal control group.The best cut-off points of HRR was determined by receiver operating characteristics(ROC)curve;the chi-square test was used to analyze the correlation of clinical characteristics with HRR;the Kaplan-Meier method was used to compare the overall survival(OS)and progression-free survival(PFS)of HRR patients in different groups;the Cox proportional risk model was used for univariate and multivariate analysis.Results:The best cut-off value of HRR was 0.936,which was divided into low HRR group and high HRR group.The low HRR group had a higher ECOG score,higher incidence of advanced Ann Arbor stage,higher NCCN-IPI score,and elevated LDH level.K-M survival analysis showed that OS(P<0.001)and PFS(P<0.001)in the low HRR group were significantly shorter than that in the higher HRR group.The multivariate analysis revealed that HRR was an independent predictor of OS(HR=0.379,95%CI:0.237-0.605,P<0.001)and PFS(HR=0.384,95%CI:0.241-0.614,P<0.001)in DLBCL patients.Conclusion:Low HRR(<0.936)in patients with DLBCL indicates a poor prognosis,which is an independent prognosis risk factor.