临床荟萃

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外周血淋巴细胞和单核细胞比值对预测弥漫大B细胞淋巴瘤复发的研究

  

  1. 1.潍坊医学院 内科学教研室,山东 潍坊 261053;2. 潍坊市人民医院 血液内科,山东 潍坊 261000
  • 出版日期:2019-12-20 发布日期:2020-01-19
  • 通讯作者: 王宝宏,Email:wfwxzhang@163.com

Peripheral blood lymphocyte  and monocyte ratio predicts relapse  in patients with diffuse large B cell lymphoma

  1. 1.Department of Internal Medicine, Weifang Medical College, Weifang  261053, China; 
    2.Department  of Hematology, Weifang  People's  Hospital, Weifang  261000, China
  • Online:2019-12-20 Published:2020-01-19
  • Contact: Corresponding author: Wang Baohong, Email: wfwxzhang@163.com

摘要: 目的  研究外周血中淋巴细胞和单核细胞比值(LMR)与弥漫性大B细胞淋巴瘤(DLBCL)患者临床特征的关系,判断预后及预测复发情况。方法  回顾性收集初治126例DLBCL患者的临床资料,应用统计学方法分析其与临床特征、预后、复发的相关关系,探讨其预测复发的价值。结果  低LMR(<2.25)组患者常伴随B症状、国际预后指数(IPI)评分增高、临床分期较晚、β2微球蛋白水平升高(P<0.05)。126例患者有43例(37.7%)复发,中位复发时间12(2~70)个月。多因素分析(OR=2.586,P=0.028)提示随访时低LMR与复发显著相关,低LMR比高LMR复发风险高,并且低LMR与较短总生存时间(OS)及无病生存时间(PFS)有关(OS:P=0.015;PFS:P=0.006)。结论  这项研究表明,LMR<2.25提示不良的预后,随诊时较低的LMR可以用作预测DLBCL患者复发的指标。

关键词: 淋巴瘤,  , B细胞, 淋巴细胞, 单核细胞, 复发, 预后

Abstract: Objective  To  investigate the relationship between peripheral blood lymphocyte and monocyte ratio (LMR) and clinical features of patients with diffuse large Bcell lymphoma (DLBCL),  and to  judge the prognosis and predict  the  relapse.Methods  The clinical data of 126 DLBCL patients was retrospectively analyzed. Statistical methods were used to analyze the relationship between clinical features,  prognosis and relapse,  and to explore the value of predicting relapse.Results  Patients in the low LMR (<2.25) group were often accompanied by B symptoms,  high IPI score,  late clinical stage,  and elevated β2microglobulin levels (P<0.05). Totally 43 cases of  126 patients (37.7%) suffered relapse,  with a median relapse time of 12 (270) months. Multivariate analysis (OR=2.586,  P=0.028)  showed that low LMR was significantly associated with relapse at followup,  low LMR was more risky than high LMR,  and low LMR was related to shorter overall survival (OS) and diseasefree survival (DFS) (OS: P=0.015; PFS: P=0.006). Conclusion  This study suggests that when LMR is less than 2.25, it indicates poor prognosis. And during the followup,  a  lower LMR can be used as a marker to predict  relapse in patients with DLBCL.

Key words: lymphoma, B cell;lymphocytes;monocytes, relapse;prognosis