目的:探讨低丙种球蛋白血症与弥漫大B细胞淋巴瘤(diffuse large B-cell lymphoma,DLBCL)患者的临床特征及其与预后的关系.方法:回顾性分析73例初治DLBCL患者治疗前血清丙种球蛋白水平,分析其与患者临床病理特征及预后的关系.根据丙种球蛋白水平,将患者分为低丙种球蛋白组(15例)和正常/高丙种球蛋白组(58例).比较2组患者临床病理特征、总生存期和疾病无进展生存期的差异,并使用Cox比例风险回归模型分析患者预后的独立危险因素.结果:在低丙种球蛋白组DLBCL患者中,高IPI评分、Ann Arbor分期(Ⅲ～Ⅳ)、β2微球蛋白水平高于正常上限、血清乳酸脱氢酶水平高于正常上限以及B症状患者的比例显著高于正常/高丙种球蛋白组(P＜0.05).低丙种球蛋白组DLBCL患者的总生存期和疾病无进展生存期更短(P＜0.05).Cox回归分析发现,高IPI评分和低丙种球蛋白是DLBCL患者预后的独立危险因素(P＜0.05).结论:初治DLBCL患者的丙种球蛋白水平与临床病理特征存在一定的相关性,低丙种球蛋白是远期总生存期和疾病无进展生存期缩短的独立危险因素,值得临床关注.
The prognostic role of hypogammaglobulinemia in newly diagnosed diffuse large B-cell lymphoma
Objective:To explore the relationship between hypogammaglobulinemia and clinical characteristics and prognosis in patients with diffuse large B-cell lymphoma(DLBCL).Methods:The pre-treatment serum immu-noglobulin levels of 73 newly diagnosed DLBCL patients were detected,and the relationship with clinical and path-ological characteristics as well as prognosis were retrospectively analyzed.The patients were divided into hypoga-mmaglobulinemia group(15 cases)and without hypogammaglobulinemia group(58 cases).The differences in clin-ical and pathological characteristics,overall survival(OS),and progression-free survival(PFS)between the two groups were compared,and Cox proportional hazards regression model was used to analyze the independent risk factors for prognosis.Results:The results showed that in the hypogammaglobulinemia group of DLBCL patients,the proportions of patients with high IPI score,Ann Arbor stage(Ⅲ-Ⅳ),β2-microglobulin levels above the upper limit of normal,serum lactate dehydrogenaselevels above the upper limit of normal and B symptoms were signifi-cantly higher than those in the patients without hypogammaglobulinemia group(P＜0.05).The OS and PFS of DLBCL patients in the hypogammaglobulinemia group were shorter than those in the patients without hypogam-maglobulinemia group(P＜0.05).Cox analysis showed that high IPI score and hypogammaglobulinemia were in-dependent risk factors for prognosis in DLBCL patients(P＜0.05).Conclusion:Hypogammaglobulinemia in new-ly diagnosed DLBCL patients is correlated with clinical and pathological characteristics,and hypogammaglobuline-mia is an independent risk factor for shorter long-term OS and PFS,which deserves clinical attention.
hypogammaglobulinemiadiffuse large B-cell lymphomaimmune dysfunctionprognosis
NETL
NSTL
万方数据
