| 尹雪,顾康生.50例套细胞淋巴瘤临床特征与预后的回顾性分析[J].安徽医药,2017,21(6):1010-1014. |
| 50例套细胞淋巴瘤临床特征与预后的回顾性分析 |
| Clinical characteristics and prognosis of 50 patients with mantle cell lymphoma:a retrospective analysis |
| 投稿时间：2016-11-26 |
| DOI： |
| 中文关键词: 套细胞淋巴瘤 预后因素 Ki-67抗原 |
| 英文关键词: Mantle cell lymphoma Prognostic factors Ki-67 antigen |
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| 中文摘要: |
| 目的 分析和探讨套细胞淋巴瘤(MCL)的临床特点、免疫表型与预后的影响因素。方法 回顾性分析50例MCL病人的临床资料、临床特征、生物学指标及治疗方案对总有效率(ORR)、无进展生存时间(PFS)、总生存期(OS)的影响。结果 50例MCL病人中位发病年龄62岁,男女比例3.5∶1,Ann-Arbor 分期Ⅲ~Ⅳ期病人为41例(82.0%)。骨髓累及者19例(38.0%),消化道侵犯者11例(22.0%)。50例病人中位生存期为61.0个月,中位无进展生存期为33.0个月。46例病人接受化疗,其中有18例病人使用化疗加利妥昔单抗；接受含与不含利妥昔单抗化疗的预期总生存期分别为74.0个月及46.5个月,差异无统计学意义(P=0.456)。全组2、3、5年生存率分别为81.3%、72.0%、54.5%,2、3年无进展生存率分别为57.8%、46.7%。白细胞计数(WBC)与乳酸脱氢酶(LDH)水平高于正常、Ki-67≥30%、CD5(＋)、MUM-1(－)均提示预后不良。多因素生存分析结果仅显示LDH水平(P=0.039),Ki-67≥30%(P=0.001)对MCL的预后差异有统计学意义,为MCL病人长期生存的独立影响因素。结论 MCL多发于老年男性,临床生物学行为具有侵袭性,常结外侵犯。治疗完全缓解率低,无疾病进展时间短,预后不佳。WBC与LDH高于正常、Ki-67≥30%、CD5(+)、MUM-1(-)是预后不良因素。LDH水平、Ki-67≥30%为MCL病人长期生存的独立影响因素。 |
| 英文摘要: |
| Objective To study the clinical characteristics,immunophenotypes and prognosis factors of mantle cell lymphoma(MCL). Methods Clinical records of 50 MCL patients admitted were analyzed retrospectively . The influence of clinical,biological indicators and therapeutic protocol on overall response rate (ORR),progression free survival (PFS) and overall survival(OS)was investigated. Results The median age of the 50 MCL patients was 62 years old,and the male-to-female ratio was 3.5∶1.Among these cases,41 (82.0%) were in Ann Arbor stage Ⅲ-Ⅳ,19(38.0%)had bone marrow involvement,11(22.0%)had digestive tract involvement. The median survival time of the 50 MCL patients was 61.0 months and the media time to progression was 33.0 months. 46 patients received chemotherapy,18 of them received chemotherapy plus rituximab. Rituximab in combination with chemotherapy was not significantly superior to chemotherapy alone in terms of OS in this study(74.0 months vs 46.5 months,P=0.456).The survival rates for 2,3 and 5 years were 81.3%,72.0% and 54.5% respectively,and the PFS rates for 2 and 3 years were 57.8% and 46.7% respectively. Leukocyte number (WBC),increased lactate dehydrogenase(LDH)level,Ki-67≥30%,CD5(+)and MUM-1(-)were poor prognostic factors. On multivariate analysis,the main predictive factors were LDH count(P=0.039),Ki-67≥30%(P=0.001).They were the independent impact factors on the survival of patients with MCL. Conclusion Most patients with MCL were elder males. Extranodal invasion is common in MCL as an aggressive tumor. The complete remission rate is low,the PFS time is short,and the prognosis is poor. Elevated LDH level and leukocyte number,Ki-67≥30%,CD5(+) and MUM-1(-) are correlated with poor prognosis. LDH count and Ki-67≥30% are the independent impact factors on the survival of patients with MCL. |
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