62例鼻型NK/T细胞淋巴瘤的预后因素分析

背景与目的:鼻型NK/T细胞淋巴瘤是具有独特生物学特性的疾病类型,由于发病率相对较低,其确切的临床预后特征尚未完全阐明。本研究拟分析华南地区鼻型NK/T细胞淋巴瘤的临床特点及可能的预后因素,为进一步的研究提供参考。方法:回顾性分析中山大学肿瘤防治中心1999年1月至2004年12月间收治的鼻型NK/T细胞淋巴瘤患者的资料。详细的临床特点及实验室检查结果均纳入单因素分析,单因素分析中有统计学意义的指标纳入多因素分析。结果:62例鼻型NK/T细胞淋巴瘤患者纳入本研究,男女比例约为3∶1,患者中位年龄42岁。92%的患者为AnnArborⅠ/Ⅱ期,76%的患者属于IPI(internationalprognosticindex)低危组。治疗前ECOGPS(performancestatus)评分0～1的患者占总数的92%,贫血见于26%的患者,而53%的患者伴随有B症状。全组患者中位生存时间27个月(95%CI:10～45个月)。单因素分析显示,性别、年龄、PS评分、乳酸脱氢酶水平、IPI、B症状、Hb(hemoglobin)浓度及白细胞数等指标与预后相关。多因素分析显示,治疗前Hb<110g/L、有B症状及PS评分>1是鼻型NK/T细胞淋巴瘤患者的不良预后因素。治疗模式的选择对患者的预后亦产生显著影响。结论:Hb浓度、B症状及PS评分可以作为判断鼻型NK/T细胞淋巴瘤预后的参考因素。

Prognostic analysis of 62 cases of nasal NK/T-cell lymphoma

BACKGROUND & OBJECTIVE: Extranodal NK/T-cell lymphoma of nasal type (ENKTL) is a rare disease entity with unique biological behavior, of which definitive characteristics are still unknown. This study was to investigate the clinical features and prognostic factors of ENKTL in the population of southern China. METHODS: Records of 62 patients with pathologically confirmed ENKTL, treated in Cancer Center of Sun Yat-sen University from Jan. 1999 to Dec. 2004, were reviewed. Detailed clinical and laboratory data were included in univariate analysis, and statistically significant factors in univariate analysis were then included in multivariate analysis. RESULTS: Of the 62 patients, 47 were men, and 15 were women, with the median age of 42; 92% of the patients had localized disease, and 76% had international prognostic index (IPI) of 0 or 1. Before treatment, 26% of the patients had anemia, 92% had ECOG performance status (PS) score of 0-1, and 53% presented B symptoms. With a median follow-up duration of 18 months, the median overall survival time was 27 months (95% CI: 10-45 months). In multivariate analysis, hemoglobin(Hb) <110 g/L, B symptoms, and ECOG PS score >1 were statistically significant unfavorable prognostic factors. CONCLUSION: Hb together with B symptoms and PS score may be independent prognostic factors for ENKTL.