RDW和PLR与弥漫大B细胞淋巴瘤患者临床特征的关系以及对预后的影响

Relationship between RDW,PLR and clinical features in patients with DLBCL and its impact on survival prognosis

目的:分析外周血红细胞分布宽度(RDW)和血小板与淋巴细胞绝对值之比(PLR)与弥漫大B细胞淋巴瘤(DLBCL)患者临床特征的关系以及对预后的影响。方法:回顾性收集我院初诊的177例DLBCL患者,同时收集122例健康体检者信息,根据ROC曲线,得出RDW、PLR最佳截取值分别为13.75%、143.37,分为高RDW组(≥13.75%)和低RDW组(<13.75%)、高PLR组(≥143.37)和低PLR组(<143.37),符合条件的150例DLBCL患者进一步应用统计学方法分析其与临床特征的相关关系及对预后的影响。结果:RDW值与贫血程度、LDH升高、IPI分组、体能状态及ESR有明显相关关系,低RDW组患者3年总生存(OS)率高于高RDW组患者(64.7%∶29.2%,P=0.001),低RDW组患者3年无进展生存(PFS)率高于高RDW组患者(71.4%∶36.2%,P=0.001);高PLR值更易伴随ESR增快,低PLR组患者3年OS率高于高PLR组患者(62.0%∶39.5%,P=0.002),低PLR组患者3年PFS率高于高PLR组患者(64.8%∶51.3%,P=0.022)。单因素分析显示,年龄、分期、体能状态、IPI分组、RDW值、PLR值及贫血为影响DLBCL患者OS、PFS的预后因素,多因素分析显示RDW及PLR是影响DLBCL患者OS和PFS的独立预测因素。结论:RDW、PLR与DLBCL患者体内炎症指标(ESR)、贫血、基础体能状态等水平相关,是影响生存的独立预测因素,或许有望成为评估DLBCL患者预后的新的参考指标。

Objective:To analyze the relationship between peripheral blood red cell distribution width(RDW),platelet-lymphocyte ratio(PLR)and clinical features in patients with diffuse large B-cell lymphoma(DLBCL),and its impact on prognosis.Method:We retrospectively collected 177 patients with DLBCL who were newly diagnosed in our hospital.We simultaneously collected information on 122 health examiners.According to the ROC curve analysis,the optimal cutoff values were 13.75%and 143.37 for RDW and PLR.The patients were divided into high RDW group(≥13.75%)and low RDW group(<13.75%),high PLR group(≥143.37)and low PLR group(<143.37).We further analyzed their relationship with clinical features and its impact on prognosis by statistical methods in 150 patients with DLBCL.Result:RDW values were significantly related to anemia,elevated LDH,IPI grouping,physical status and ESR.The 3-year overall survival rate(OS)in the low RDW group was higher than that in the high RDW group(64.7% vs 29.2%,P=0.001).The 3-year progression-free survival(PFS)rate in patients with low RDW was higher than that in patients with high RDW(71.4% vs 36.2%,P=0.001).High PLR values were more likely to have ESR increase,they were positive correlated.The 3-year OS rate in low PLR group was higher than that in patients with high PLR value(62.0% vs 39.5%,P=0.002),and the 3-year PFS rate in low PLR group was higher than that in patients with high PLR(64.8% vs 51.3%,P=0.022).Univariate analysis showed that age,stage,physical status,IPI group,RDW,PLR and anemia were prognostic factors affecting OS and PFS in patients with DLBCL.Multivariate analysis showed that RDW and PLR were independent predictors of OS and PFS in patients with DLBCL.Conclusion:PLR and RDW are significantly correlated with the level of inflammation index(ESR),anemia and basic physical status,which are independent predictors of survival and may be a new reference index for evaluating the prognosis of patients with DLBCL.