78例T细胞非霍奇金淋巴瘤预后因素分析

目的：探讨T细胞非霍奇金淋巴瘤（NHL）临床病理因素与预后的关系。方法：回顾我院近8年的首诊初治T细胞NHL患者78例，记录每位患者治疗前的年龄、性别、病理类型、临床分期、ECOG评分、最大肿瘤直径、结外受累部位数、有无B症状、LDH水平、β2MG水平、国际预后指数（IPI）、治疗方案、治疗效果、无进展生存期（PFS）及总生存期（OS）。应用免疫组化方法检测Ki-67及Survivin的表达情况。应用SPSS16．0进行统计学分析，探讨各临床病理因素与预后的关系。结果：年龄、临床分期、ECOG评分、最大肿瘤直径、LDH水平、IPI、疗效、Ki-67及Survivin的表达是影响PFS的单个因素。年龄、临床分期、ECOG评分、最大肿瘤直径、IPI、疗效、Ki-67及Survivin的表达是影响OS的单个因素。多因素分析表明Ki-67及Survivin的表达均为影响PFS及OS的独立预后因素。结论：Ⅺ-67及Survivin的表达水平是T细胞NHL重要的预后因素．是对IPI的重要补充，将两者与IPI相结合对估计患者的病情发展、制定个体化治疗策略有重要意义。

Prognostic factors analysis of 78 cases with T-cell non-Hodgkin's lymphoma

Objective： prognosis of T-cell non-H To analyse the relationship between the clinical pathological factors and odgkin＇s lymphoma （NHL）. Methods： 78 patients with untreated T-cell NHL were reviewed and every patients＇ age, gender, pathological type, clinical staging, ECOG performance status, maximum diameter of tumor, number of tumor site excluding lymphoid nodule, with B symptom or not, LDH level, 132MG level, international prognostic index （IPI）, scheme of treatment, response to chemotherapy, progression-free survival （PFS） and overall survival （OS） were recorded. The expression of Ki-67 and Survivin were determined by the methods of immunohistochemistry. The relationship between the clinical pathological factors and prognosis was analysed by SPSS 16.0. Results： Age, clinical staging, ECOG performance status, maximum diameter of tumor, LDH level, IPI, curative effect, Ki-67 and Survivin were prognostic factors that could influence PFS. Clinical staging, ECOG performance status, maximum diameter of tumor, IPI, curative effect, Ki-67 and Survivin were prognostic factors that could influence OS. Multivariate analysis confirmed Ki-67 and Survivin were independent prognostic factors related to PFS and OS. Conclusion： Ki-67 and Survivin expression level are two very important prognostic factors for patients of T-cell NHL. They are important complements to IPI. And the combination of these three factors is significant to estimate the progress of illness and design the individual strategy of treatment.