非上呼吸消化道结外NK/T细胞淋巴瘤的不良预后因素分析 |
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引用本文: | 马咪静,杨珍珍,尹美凤,杨万秋,丁梦杰,朱利楠,董萌,张蕾,李鑫,孙振昌,李玲,王冠男,张旭东,张明智,陈清江. 非上呼吸消化道结外NK/T细胞淋巴瘤的不良预后因素分析[J]. 中国肿瘤临床, 2018, 45(18): 939-942. DOI: 10.3969/j.issn.1000-8179.2018.18.742 |
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作者姓名: | 马咪静 杨珍珍 尹美凤 杨万秋 丁梦杰 朱利楠 董萌 张蕾 李鑫 孙振昌 李玲 王冠男 张旭东 张明智 陈清江 |
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作者单位: | ①.郑州大学第一附属医院肿瘤内科(郑州市450052) |
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基金项目: | 国家自然科学基金面上项目81470364 |
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摘 要: | 目的 分析非上呼吸消化道来源的结外NK/T细胞淋巴瘤(non-upper aerodigestive tract extranodal NK/T-cell lymphoma,NUAT-ENKTCL)的不良预后因素。 方法 回顾性分析郑州大学第一附属医院2011年1月至2015年12月收治的20例NUAT-NKTCL患者临床资料,采用Kaplan-Meier法进行生存分析,应用Log-Rank法检验对EBER表达、年龄、性别、乳酸脱氢酶(lactic dehydrogenase,LDH)水平和治疗前外周血EBV-DNA拷贝数等进行单因素分析。 结果 20例患者中,男女比为13:7。中位年龄为39(12~66)岁,其中≥60岁3例(15%), < 60岁17例(85%)。Ann Arbor分期:Ⅰ、Ⅱ期8例(40%),Ⅲ、Ⅳ期12例(60%)。LDH水平升高12例(60%)。治疗前外周血EBV-DNA拷贝数增加11例(55%)。病变组织中EBER(+)13例(65%)。患者截至随访时间死亡4例,生存16例,中位总生存期(median overall survival,mOS)为15.4个月,中位无进展生存期(median progression free survival,mPFS)为8个月。完全缓解(complete response,CR)11例(55%),部分缓解(partial response,PR)5例(25%),客观缓解率(objective response rate,ORR)为80%。单因素分析显示年龄与预后呈显著相关性。 结论 EBER的表达并不影响NUAT-ENKTCL患者的预后,年龄≥60岁患者预后较差。
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关 键 词: | 非上呼吸消化道NK/T细胞淋巴瘤 EBER表达 生存分析 预后 |
收稿时间: | 2018-07-15 |
Analysis of adverse prognostic factors of non-upper aerodigestive tract extranodal NK/T-cell lymphoma |
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Affiliation: | ①.Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China②.Lymphoma Diagnosis and Treatment Center of Henan Province, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China③.The Third Affiliated Hospital of Xinxiang Medical College, Xinxiang 453000, China④.Department of Pathology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China |
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Abstract: | Objective To investigate the prognostic factors of non-upper aerodigestive tract extranodal NK/T- cell lymphoma (NUATNKTCL). Methods Samples from twenty patients with NUAT-NKTCL, who were treated in The First Affiliated Hospital of Zhengzhou University between January 2011 and December 2015, were collected. The overall survival (OS) and progression-free survival (PFS) time of these patients were estimated by the Kaplan-Meier method. Through the log-rank test, the survival curves were compared among EBER expression, age, lactate dehydrogenase (LDH) level, EBV-DNA copies, and gender. Results The male-female ratio of patients was 13:7. The median age was 39 years (range 12-66), with 3 patients above 60 years (15%) and the others below 60 years (85%). Forty percent of the patients were Ann-Arbor stage Ⅰ/Ⅱ and 60% of them were Ann-Arbor stage Ⅲ/Ⅳ. Twelve patients (60%) had a high level of LDH. Eleven patients had a high level of EBV-DNA copies in peripheral blood (55%) before treatment. Thirteen patients were EBER positive. Among the 20 patients, 4 patients died and 16 survived. The median OS was 15.4 months, and the median PFS was 8 months. Eleven patients received CR, 5 achieved PR while the ORR was 80%. The Log-rank test showed a significant association between age and prognosis (P=0.001). Conclusions There was no correlation between EBER expression and prognosis of NUAT-NKTCL. Patients over 60 years of age had a poor prognosis. |
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