摘要
目的 探讨血清乳酸脱氢酶(LDH)、β2-微球蛋白(β2-MG)及铁蛋白水平与侵袭性B细胞淋巴瘤患者预后的关系.方法 选取60例侵袭性B细胞淋巴瘤患者,均接受利妥昔单抗+环磷酰胺+表柔比星+长春新碱+泼尼松(R-CHOP)方案化疗,治疗4个疗程后评估临床疗效,检测治疗前后患者血清LDH、β2-MG、铁蛋白水平.随访3年,比较不同预后侵袭性B细胞淋巴瘤患者治疗4个疗程后血清LDH、β2-MG、铁蛋白水平,其与患者预后的相关性采用Spearman秩相关分析.结果 60例侵袭性B细胞淋巴瘤患者化疗4个疗程后,完全缓解38例,部分缓解7例,疾病稳定4例,疾病进展11例,疾病控制率为81.67％(49/60).治疗4个疗程后,侵袭性B细胞淋巴瘤患者血清LDH、β2-MG、铁蛋白水平均明显低于治疗前,差异均有统计学意义(P＜0.01).随访3年,所有患者均无失访,生存43例,死亡17例.生存患者治疗4个疗程后血清LDH、β2-MG、铁蛋白水平均明显低于死亡患者,差异均有统计学意义(P＜0.01).Spearman秩相关分析结果显示,血清LDH、β2-MG、铁蛋白水平与侵袭性B细胞淋巴瘤患者的预后生存均呈负相关(r=-0.718、-0.823、-0.753,P＜0.05).结论 血清LDH、β2-MG、铁蛋白水平与侵袭性B细胞淋巴瘤患者的预后生存均呈负相关,有助于临床对患者的预后进行客观评价.
Abstract
Objective To explore the relationship between serum lactate dehydrogenase(LDH),β2-microglobulin(β2-MG),ferritin levels and prognosis in patients with invasive B-cell lymphoma.Method A total of 60 patients with inva-sive B-cell lymphoma were selected,all patients received rituximab+cyclophosphamide+epirubicin+vincristine+prednisone(R-CHOP)regimen chemotherapy.The therapeutic effect was evaluated after 4 courses of treatment,and lev-els of serum LDH,β2-MG,and ferritin levels were detected before and after treatment.Followed up for 3 years,the serum LDH,β2-MG,and ferritin levels in patients with invasive B-cell lymphoma with different prognosis after 4 courses of treatment were compared,and their correlation with patients prognosis was analyzed by Spearman rank correlation analy-sis.Result After 4 courses of treatment,in 60 patients with invasive B-cell lymphoma,38 cases showed complete re-sponse,7 cases showed partial response,4 cases showed stable disease,and 11 cases showed progressive disease,the dis-ease control rate was 81.67％(49/60).After 4 courses of treatment,the serum LDH,β2-MG and ferritin levels in patients with invasive B-cell lymphoma were significantly lower than those before treatment,the differences were statistically sig-nificant(P＜0.01).Followed up for 3 years,there was no loss of follow-up for all patients,with 43 surviving cases and 17 death cases.The serum LDH,β2-MG,and ferritin levels of surviving patients after 4 courses of treatment were significant-ly lower than those of death patients,and the differences were statistically significant(P＜0.01).Spearman rank correla-tion analysis results showed that serum LDH,β2-MG,and ferritin levels were negatively correlated with the prognosis sur-vival of patients with invasive B-cell lymphoma(r=-0.718,-0.823,-0.753,P＜0.05).Conclusion Levels of serum LDH,β2-MG,and ferritin are negatively correlated with the prognosis survival of patients with invasive B-cell lymphoma,which helps to objectively evaluate the prognosis of patients in clinical practice.
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