血清铁蛋白及LDH检测对侵袭性淋巴瘤预后意义

PROGNOSTIC SIGNIFICANCE OF SERUM FERRITIN AND LACTATE DEHYDROGENASE IN PATIENTS WITH AGGRESSIVE LYMPHOMA

目的 探讨血清铁蛋白(FERR)及乳酸脱氢酶(LDH)检测对初治侵袭性淋巴瘤病人预后意义。方法回顾性分析于我院就诊的182例初治侵袭性淋巴瘤病人的临床资料。根据受试者工作特征(ROC)曲线计算约登指数得出血清FERR、LDH截断值,据此将病人分为高FERR高LDH组(47例)、低FERR低LDH组(67例)和其他组(68例,包括低FERR高LDH组42例和高FERR低LDH组26例),分析血清FERR、LDH水平对初治侵袭性淋巴瘤病人预后的影响。结果 中位随访时间22个月,血清FERR、LDH联合检测的曲线下面积(AUC)高于两者单独检测的AUC。高FERR高LDH组病人的总生存时间(OS)和无进展生存时间(PFS)均短于另外两组,差异具有统计学意义(χ^(2)=30.568、40.759,P<0.001)。多因素分析显示,血清FERR是影响初治侵袭性淋巴瘤病人OS、PFS的独立危险因素。结论 血清FERR、LDH联合检测是判断初治侵袭性淋巴瘤病人预后的有用指标,二者水平均升高提示病人预后较差。

Objective To investigate the prognostic significance of combined detection of serum ferritin(FERR) and lactate dehydrogenase(LDH) in previously untreated patients with aggressive lymphoma. Methods The clinical data of 182 pre-viously untreated patients with aggressive lymphoma who were admitted to our hospital were analyzed retrospectively. The cut-off values of serum FERR and LDH were determined by calculating the Youden’s index based on the receiver operating characteristic(ROC) curve. According to the cut-off values, patients were divided into high FERR and high LDH group(n=47), low FERR and low LDH group(n=67), and other group(n=68, including 42 patients with low FERR and high LDH and 26 patients with high FERR and low LDH). The influence of serum FERR and LDH on the prognosis of previously untreated patients with aggressive lymphoma was analyzed. Results The median follow-up time was 22 months. The area under the ROC curve of the combined measurement of serum FERR and LDH was higher than that of serum FERR or LDH alone. Patients in the high FERR and high LDH group had significantly shorter overall survival(OS) and progression-free survival(PFS) than those in the other two groups(χ^(2)=30.568,40.759;P<0.001). Multivariate analysis showed that serum FERR was an independent risk factor for OS and PFS in previously untreated patients with aggressive lymphoma. Conclusion The combined measurement of serum FERR and LDH is a useful indicator for evaluating the prognosis of previously untreated patients with aggressive lymphoma. Elevated levels of both se-rum FERR and LDH indicate a poor prognosis in patients.