成都地区淋巴瘤患者血清游离轻链与不良临床特征及血液常规参数的关系研究

Study on the Correlation between Elevated Serum Free Light Chain and Inferior Clinical Features or Hematological Parameters of Lymphoma Patients in Chengdu Area

目的:探讨成都地区淋巴瘤人群中血清游离轻链(sFLC)与不良的临床特征及血液常规参数之间的关系。方法:从2019年4月至2021年7月在四川省人民医院确诊的274例淋巴瘤患者中选取249例非霍奇金淋巴瘤(NHL)纳入本研究,分别对其sFLC、临床特征及血液常规参数进行回顾性分析。sFLC正常组与sFLC增高组之间临床特征的差异比较采用卡方检验;sFLC正常组与sFLC增高组之间血液常规参数的差异比较采用卡方检验和非参数检验方法Mann-Whitney U检验。结果:共249例NHL,138例(55.42%)sFLC增高,其中9.24%(23例)为单克隆增高,46.18%(115例)为多克隆增高。大多数NHL患者存在sFLC增高,但增高的sFLC因分泌类型(单克隆或多克隆)、淋巴瘤分型的变化而不同。年龄、性别、疾病分级、IPI预后指数、B症状、骨髓侵犯等临床特征在NHL患者sFLC增高组与sFLC正常组之间差异无统计学意义(P>0.05)。但是,与sFLC正常组相比,sFLC增高组的患者均存在较高的WBC、ANC、AMC、hsCRP、Cr、Glb、LDH以及较低的Hb和Alb(P<0.05)。结论:sFLC增高与较差的血液常规参数相关,揭示了sFLC在成都地区淋巴瘤人群中独特的诊断和预后价值。

Objective:To analyze the correlation of the serum free light chain elevated(sFLC)and clinical characteristics and hematological parameters of lymphoma in Chengdu area.Methods:249 cases of non-Hodgkin lymphoma(NHL)out of 274 patients with lymphoma diagnosed in Sichuan People′s Hospital from April 2019 to July 2021 were selected,the sFLC,clinical features and hematological parameters of the patients were analyzed retrospectively.The difference of clinical features between the patients with normal sFLC and elevated sFLC was examined by chi-square test.The difference of hematological parameters between patients with normal sFLC and elevated sFLC were examined by chi-square test and nonparametric Mann-Whitney U test.Results:Among the 249 NHL patients,55.42%(138/249)patients had an elevated sFLC,of which 9.24%(23/138)were being monoclonal and 46.18%(115/138)were polyclonal.The sFLC elevation was common in NHL,but varied according to the types of sFLC secretion(monoclonal or polyclonal),and types of lymphoma.Furthermore,there were no significant statistical differences in clinical characteristics,including age,sex,stage disease,International Prognostic Index(IPI),B symptoms,and bone marrow invasion between elevated sFLC and normal sFLC of the NHL patients(P>0.05).However,the patients with elevated sFLC had adverse hematological parameters more frequently,including higher WBC,ANC,AMC,hsCRP,Cr,Glb,LDH,and lower Hb,Alb.Conclusion:Elevated sFLC is associated with inferior hematological parameters,revealing the uniqueness of the diagnostic and prognostic value of sFLC in lymphoma in chengdu area.