29例 CD5阳性弥漫大B 细胞淋巴瘤患者的临床预后分析

目的：探讨 CD5阳性弥漫大 B 细胞淋巴瘤的预后影响因素。方法回顾性分析了29例 CD5阳性弥漫大 B 细胞淋巴瘤患者临床资料及随访数据，采用 Kaplan-Meier 法估算患者的生存时间，采用 COX 比例风险模型进行预后影响因素分析。结果29例 CD5阳性弥漫大 B 细胞淋巴瘤患者1、2年无事件生存率分别为483%、255%，中位疾病无进展生存时间为10个月。全组患者1、2、3年总生存率分别为586%、449%、318%，中位总生存时间为19个月。单因素分析结果显示：不同的 Ann Arbor 分期、LDH 水平、IPI评分、结外受累范围、病理分型、利妥昔单抗的使用与否对总生存时间有显著影响（P ＜005）。COX 多因素回归分析结果显示：影响总生存时间的独立预后因素为 Ann Arbor 分期、病理类型及利妥昔单抗的使用与否。结论 CD5表达是 DLBCL 的不良预后因素，病理类型、Ann Arbor 分期及利妥昔单抗的使用是 CD5阳性 DLBCL 影响患者总生存期的独立预后因素。

Clinical Prognosis Analysis of 29 Patients with CD5-positive Diffuse Large B-cell Lymphoma

Objective To analyze the prognosis ofCD5-positive diffuselarge B-cell lymphoma Methods The clinical profiles and follow-up data of 29 patients with CD5-positive diffuse large B-cell lymphoma were retrospec-tively analyzed Kaplan-Meier method was applied to estimate the survival time of all patients,while COX proportion-al hazard model was used to investigate the association between clinicopathologic features with prognosis Results The 1-,2-year progression -free survival rate were 48 3% ,25 5% ,respectively;the median progression -free surviv-al was 10 months The 1-,2-and 3- year overall survival rates were 58 6% ,44 9% ,31 8% ,respectively;the medi-an overall survival was 19 months Univariate analysis revealed that the overall survival was significantlyinfluenced by Ann Arbor stage,LDH level,IPI score,extranodal disease,immunohistochemistry classification,treatment withri-tuximab((P < 0 05)COX regression model revealed that only Ann Arbor stage,immunohistochemistry classifica-tion and treatment with rituximabwere the independent prognostic factors for overall survival Conclusion CD5 ex-pression is an adverse prognostic factor in diffuse large B-cell lymphoma,Ann Arbor stage,immunohistochemistry classification and treatment with rituximab are independent prognostic factors for overall survival of CD5-positive dif-fuse large B-cell lymphoma.