滤泡性淋巴瘤的侵袭性转化及预后分析

Analysis of Histologic Transformation and Prognosis for Follicular Lymphoma

目的:探讨滤泡性淋巴瘤(FL)侵袭性转化和预后的相关因素。方法:收集2015年8月至2021年1月本院收治的168例FL患者的临床资料,分析各指标在组织学转化(HT)及预后中的意义。结果:病理3级、Ki-67≥40%、β_(2)-MG>3 mg/L、LDH>245 U/L、POD24、骨髓未受侵犯与HT相关。单因素分析结果显示,FLIPI-2高危、病理3级、Ki-67指数≥40%、贫血、β_(2)-MG>3 mg/L、LDH>245 U/L、HT是影响PFS的不良因素;β_(2)-MG>3 mg/L、LDH>245 U/L、POD24、HT是影响OS的不良因素。Cox多因素分析结果显示,β_(2)-MG>3 mg/L、HT是PFS的独立危险因素;HT是OS的独立危险因素。结论:FL中病理分级、Ki-67指数、β_(2)-MG、LDH、POD24及骨髓累及与否可预测HT风险,同时HT、β_(2)-MG>3 mg/L与FL预后不良有关。

Objective:To investigate the related factors of invasive transfommation and prognosis for follicular lymphoma.Methods:A total of 168 patients with follicular lymphoma at First Affiliated Hospital of Zhengzhou University from August 2015 to January 2021 were collected,and the significance of each index in histological transformation(HT)and prognosis were analyzed.Results:Pathology grade3,Ki67 index≥40%,β_(2)-MG>3 mg/L,LDH>245 U/L,POD24 and non-invasion of bone marrow were associated with HT.Univariate analysis showed that the high risk of FLIPI-2,pathological grade 3,Ki-67≥40%,anemia,β_(2)-MG>3 mg/L,LDH>245 U/L and HT had significant adverse effects on PFS;β_(2)-MG>3 mg/L,LDH>245 U/L,POD24 and HT had significant adverse effects on OS.Cox multivariate analysis showed that theβ_(2)-MG>3 mg/L and HT were independent risk factors of PFS,HT was independent risk factor of OS.Conclusion:The pathological grade,Ki-67,β_(2)-MG,LDH,POD24 and bone.marrow invasion of FL can predict the risk of HT.Meanwhile,β_(2)-MG>3 mg/L and HT are significantly related to poor prognosis of FL.