弥漫性大B细胞淋巴瘤预后相关因素的研究

目的分析弥漫性大B细胞淋巴瘤（DLBCL）患者的病理学特征以及影响其预后的相关因素。方法采用单因素及Cox多因素分析方法，对影响DLBCL预后的相关因素进行分析。结果60例DLBCL患者中共有47例（78．33％）侵犯淋巴结，13例（21．67％）结外侵犯。经单因素分析显示，影响DLBCL患者的预后因素包括年龄、临床分期、PS分级、结外病灶数、血清LDH、近期疗效。经Cox多因素分析显示患者年龄、近期疗效、临床分期是影响患者预后的独立危险因素。根据国际预后指数（IPI）将患者分为低危组、低中危组、高中危组及高危组，各组5年生存率分别为70．59％（12／17）、57．14％（12／21）、41．67％（5／12）、10．00％（1／10），差异有统计学意义（P〈0．05）。联合治疗DLBCL患者的5年生存率显著高于单纯性放化疗或手术治疗患者。结论影响DLBCL患者预后的独立因素包括年龄、近期疗效、临床分期，采用多种方式联合治疗的方案能提高DLBCL患者临床治愈率。

Study of Prognostic Factors of Diffuse Large B-cell Lymphoma

Objective To study the pathological features of diffuse large B-cell lymphoma（DLBCL） and its related prognosis factors. Methods Related prognosis factors of DLBCL patients were analyzed by univariate and multivariate Cox analysis methods. Results There were 47 cases of（78.33% ） lymph node involvement and 13 cases of（21.67% ） extranodal involvement in the 60 DLBCL patients. Univariate analysis showed that factors affecting the prognosis of patients with DLBCL, including age, clinical stage, PS classification, extranodal involvement, serum LDH and short-term effect. Cox multivariate analysis showed that the patient＇s age, short-term effect, clinical stage were independent risk factors affecting prognosis. According to the International Prognostic Index（ IPI）, patients were divided into the low-risk,low-intermediate-risk, high-intermediate- risk, and high risk group, the 5-year survival rates were 70.59 % （ 12/17 ） ,57.14% （ 12/21 ） ,41.67% （5/12）, 10.00% （ 1/10 ）, respectively, the difference was statistically significant（ P 〈 0.05 ）. The 5-year survival rate of DLBCL patients treated with combination therapy was significantly higher than those patients received simple radiotherapy and chemotherapy or surgery. Conclusion Age, short-term effect and clinical stage are independent prognostic factors of DLBCL, and combination therapy can improve the clinical cure rate of DLBCL patients.