红细胞分布宽度与血红蛋白/红细胞分布宽度比值在霍奇金淋巴瘤中的预后价值

Prognostic value of red blood cell distribution width and hemoglobin-to-red blood cell distribution width ratio in the Hodgkin’s lymphoma

目的探讨红细胞分布宽度(RDW)、血红蛋白/红细胞分布宽度比值(HRR)与霍奇金淋巴瘤(HL)患者临床特征及预后的关系。方法回顾性分析2014年1月至2021年1月郑州大学第一附属医院收治的292例HL患者的临床资料。采用受试者工作曲线(ROC)确定RDW、HRR的最佳临界值,比较分析RDW、HRR与HL临床特征的关系,Kaplan-Meier曲线和long rank检验绘制并比较不同水平HRR患者的总生存(OS)和疾病无进展生存(PFS),单因素及多因素Cox比例风险回归模型分析影响HL预后的风险因素。结果ROC曲线确定RDW、HRR的最佳临界值分别为15.25、8.85。RDW≥15.25、HRR<8.85与结外侵犯、高IPS评分、低血红蛋白、低淋巴细胞、低白蛋白等预后不良因素密切相关。Kaplan-Meier生存曲线显示RDW≥15.25、HRR<8.85组的OS、PFS更差。多因素Cox比例风险回归模型分析结果显示,HRR为PFS的独立预测因素。结论初诊时低HRR与HL患者不良预后密切相关。

Objective The study aimed to investigate the prognostic value of red blood cell distribution width(RDW)and hemoglobin-to-red blood cell distribution width ratio(HRR)in the patients with Hodgkin’s lymphoma(HL).Methods The clinical data of 292 HL patients who were admitted to the First Affiliated Hospital of Zhengzhou University between January 2014 and January 2021 were retrospectively analyzed.The best cut-off points of RDW,HRR for predicting prognosis were determined by receiver operating characteristic(ROC)curve.The correlations of clinical factors with RDW as well as HRR were analyzed.Overall survival(OS)rate and progression-free survival(PFS)curves were plotted by using the Kaplan-Meier method,and were analyzed by using the log-rank test.Univariate and multivariate Cox proportional hazard regression models were used to analyze independent prognostic factors.Results The optimal critical values of RDW and HRR determined by ROC curve were 15.25,8.85,respectively.RDW≥15.25 and HRR<8.85 were associated with poor prognostic factors,such as extra-nodal invasion,high IPS scores,low hemoglobin,low lymphocyte levels as well as low albumin.Kaplan-Meier analyses revealed that RDW≥15.25,HRR<8.85 were associated with poor OS and PFS.In multivariate analysis,HRR<8.85 was an independent predictor of a poor PFS.Conclusion Low HRR at initial diagnosis is closely related to poor prognosis of patients with HL.