García Zueco J C, Delgado M P, Giraldo M P, Perella M, Rubio-Félix D, Giralt M
Servicio Regional de Hematología y Hemoterapia, Hospital Miguel Servet, Zaragoza.
Sangre (Barc). 1992 Oct;37(5):337-44.
To analyse different clinico-biologic data in order to assess their prognostic value in non-Hodgkin's lymphoma (NHL) patients.
The series comprises 307 patients with NHL diagnosed and treated between 1975 and 1988. The histopathologic diagnosis was revised in accordance with the working formulation system, three prognostic groups being thus considered: low-grade (LGL), intermediate-grade (IGL) and high-grade (HGL) lymphomas. Age, sex, clinical course prior to diagnosis, presence of B symptoms, histologic type, number of lymph-node areas involved, bulky disease, anaemia, thrombocytopenia, LDH, stage and response to therapy were all evaluated for the study. Survival curves were drawn with the Kaplan-Meier method, and the log-rank test was used for comparison of median survival. Whenever the univariate analysis achieved statistical significance, a multivariate analysis was performed by means of a multiple correlation and regression study in accordance with the Cox's model, in which the variables were expressed in a binary model.
The following 8 values were found significant in the univariate study of low-grade lymphomas: age, number of involved areas, bulky disease anaemia, thrombocytopenia, LDH, stage, and initial response to treatment. In intermediate-grade lymphomas, the significant findings were age, number of affected areas, bulky disease, thrombocytopenia, LDH, stage, and initial response. For high-grade lymphomas, number of affected areas, thrombocytopenia, LDH, stage and initial response were found statistically significant. Although no significant differences were found for survival within each of the three grades, such differences were significant between them. In the multivariate analysis, age was significant only in the LGL (p < 0.0001) in IGL, age (p < 0.07) and initial response to therapy (p < 0.0001) achieved significant value, and in HGL, stage (p < 0.02) and initial response to treatment (p < 0.0001) attained significance.
The univariate analysis provides various prognostic factors of statistically significance, as reported in the literature, but these after the multivariate analysis was applied, were reduced to age, stage and initial response to treatment.
分析不同的临床生物学数据,以评估其在非霍奇金淋巴瘤(NHL)患者中的预后价值。
该系列包括1975年至1988年间诊断和治疗的307例NHL患者。根据工作分类系统对组织病理学诊断进行了修订,从而考虑了三个预后组:低度(LGL)、中度(IGL)和高度(HGL)淋巴瘤。对年龄、性别、诊断前的临床病程、B症状的存在、组织学类型、受累淋巴结区域数量、大包块病变、贫血、血小板减少、乳酸脱氢酶(LDH)、分期和治疗反应均进行了评估以用于该研究。采用Kaplan-Meier方法绘制生存曲线,并使用对数秩检验比较中位生存期。只要单因素分析达到统计学显著性,就根据Cox模型通过多元相关和回归研究进行多因素分析,其中变量以二元模型表示。
在低度淋巴瘤的单因素研究中,发现以下8个值具有显著性:年龄、受累区域数量、大包块病变、贫血、血小板减少、LDH、分期和初始治疗反应。在中度淋巴瘤中,显著发现为年龄、受累区域数量、大包块病变、血小板减少、LDH、分期和初始反应。对于高度淋巴瘤,受累区域数量、血小板减少、LDH、分期和初始反应具有统计学显著性。尽管在三个级别中的每一级别内生存无显著差异,但它们之间的差异具有显著性。在多因素分析中,年龄仅在低度淋巴瘤中具有显著性(p<0.0001),在中度淋巴瘤中,年龄(p<0.07)和初始治疗反应(p<0.0001)具有显著意义,在高度淋巴瘤中,分期(p<0.02)和初始治疗反应(p<0.0001)具有显著意义。
如文献报道,单因素分析提供了各种具有统计学显著性的预后因素,但在应用多因素分析后,这些因素减少为年龄、分期和初始治疗反应。