套细胞淋巴瘤18例的预后相关因素分析

Prognostic factors of mantle cell lymphomas: analysis of 18 cases

摘要:

目的 通过分析套细胞淋巴瘤（MCL）的临床特征，探讨影响预后的相关因素，指导临床实践。方法 收集2008年7月至2014年7月收治的18例MCL患者的临床资料，回顾性地分析性别、年龄、套细胞淋巴瘤国际预后指数（MIPI）评分、骨髓受侵情况、美国东部肿瘤协作组（ECOG）评分、B症状、Ki-67水平、乳酸脱氢酶（LDH）、白细胞（WBC）、淋巴细胞（LYM）、临床分期、首次治疗方法等各因素，采用Fisher精确检验对累积生存率进行比较，生存资料及预后分析采用乘积极限法（Kaplan-Meier法）绘制生存曲线。多因素分析采用Cox比例风险模型分析各临床要素对疾病预后的影响。结果 年龄＜65岁与≥65岁分组（P＝0.036）、MIPI评分低危、中危、高危分组（P＝0.049）、ki-67＜30%或≥30%（P＝0.001）与预后具有相关性，而性别、B症状、ECOG评分、β2微球蛋白、LDH、WBC、LYM、临床分期、首次治疗方法统计后差异无统计学意义（P＞0.05）。结论 患者的年龄＜65岁预后好。MIPI评分中、低危组预后好，高危组预后差。免疫表型中Ki-67＜30%较≥30%的患者预后好。

Abstract:

Objective To investigate the clinical features of mantle cell lymphoma (MCL) and the prognostic factors in order to guide the clinical practice. Methods Clinical data of 18 patients with MCL admitted in our hospital from July 2008 to July 2014 were collected and retrospectively analyzed in this study. Their sex, age, B symptoms, invasion of bone marrow, scores of Mantle Cell Lymphoma International Prognostic Index (MIPI), Eastern Cooperative Oncology Group (ECOG) scores, serum levels of Ki-67 and lactate dehydrogenase (LDH), white blood cell (WBC) and lymphocyte (LYM) counts, clinical stages, initial therapy and clinical outcomes were analyzed. Fisher exact test was used to compare the cumulative survival. Kaplan-Meier survival analysis was employed to draw survival curve. The prognostic factors were analyzed by Cox proportional hazard model. Results Age (younger or older than 65 years, P＝0.036), MIPI scores (low-, medium- and high-risk, P＝0.049) and Ki-67 level (＜30% and ≥30%, P＝0.001) were correlated with prognosis, but sex, ECOG scores, B symptoms, β2-microglubulin, LDH level, WBC count, LYM count, clinical stages and initial therapy were not (P＞0.05). Conclusion Younger than 65 years, low or medium MIPI scores and Ki-67 below 30% are favorable prognostic factors for MCL.