慢性鼻-鼻窦炎对鼻型结外NK/T细胞淋巴瘤分期及预后的影响

Effects of chronic rhinosinusitis on the clinical stage and prognosis of nasal type extranodal natural killer/T-cell lymphoma

目的:探究慢性鼻-鼻窦炎(CRS)对鼻型结外NK/T细胞淋巴瘤(ENKTL-NT)分期及预后的影响。方法:回顾性分析郑州大学第一附属医院肿瘤科2011年3月至2021年2月收治的134例经组织病理学确诊的ENKTL-NT患者的临床资料。其中110例(82.1%)发病前存在CRS病史,CRS病程≤10 a 88例,>10 a 22例;无CRS病史24例。结果:无CRS病史组、CRS病程≤10 a组、CRS病程>10 a组患者的性别、年龄、合并B症状情况、IPI评分、PINK-E评分、血浆EBV-DNA载量、血清LDH水平、骨髓侵犯情况等方面差异均无统计学意义(P>0.05)。CRS病程与ENKTL-NT患者的CA分期存在正相关性(r_(S)=0.175,P=0.043)。一线治疗2个周期后,3组近期疗效差异无统计学意义(P=0.260)。134例随访1~118个月,3组的无疾病进展生存(PFS)生存曲线差异有统计学意义(P=0.018);Cox回归分析结果显示,CRS病程>10 a是影响ENKTL-NT PFS的危险因素,HR(95%CI)为2.912(1.116~7.601)。结论:CRS病程与ENKTL-NT患者的临床分期有正相关性,并可能影响ENKTL-NT远期预后。

Aim:To investigate the effects of chronic rhinosinusitis(CRS)on the clinical stage and prognosis of nasal type extranodal natural killer/T-cell lymphoma(ENKTL-NT).Methods:Clinical data of 134 ENKTL-NT patients histologically confirmed by the First Affiliated Hospital of Zhengzhou University from March 2011 to February 2021 were retrospectively analyzed.Among them,110 cases(82.1%)had a history of CRS before the onset,88 cases had a history of CRS less than 10 years and 22 cases more than 10 years;24 cases had no history of CRS.Results:There was no significant difference in gender,age,combined B symptoms,IPI score,PINK-E score,plasma EBV-DNA load,serum LDH level or bone marrow invasion among the 3 groups(P>0.05).CRS course was positively correlated with the CA stage of ENKTL-NT(r_(S)=0.175,P=0.043).After 2 cycles of first-line treatment,there was no significant difference in the short-term efficacy among the 3 groups(P=0.260).All the cases were followed up for 1-118 months.The analysis of Kaplan-Meier survival curve showed that the progression free survival(PFS)of the 3 groups had significant difference(P=0.018);Cox regression analysis showed that the CRS course more than 10 years was a risk factor of PFS of ENKTL-NT,and the HR(95%CI)was 2.912(1.116-7.601).Conclusion:CRS course may be correlated with the clinical stage of ENKTL-NT,and may affect the long-term prognosis.