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血清β2-微球蛋白可预测上呼吸消化道 NK/T 细胞淋巴瘤患者的预后。

Serum beta2-microglobin is a predictor of prognosis in patients with upper aerodigestive tract NK/T-cell lymphoma.

机构信息

State Key Laboratory of Oncology in Southern China, Department of Medical Oncology, Sun Yat-sen University Cancer Center, 651 Dong Feng RD East, Guangzhou, China.

出版信息

Ann Hematol. 2012 Aug;91(8):1265-70. doi: 10.1007/s00277-012-1434-1. Epub 2012 Feb 29.

Abstract

Upper aerodigestive tract natural killer (NK)/T-cell lymphoma (UNKTL) is the most common type of extranodal NK/T-cell lymphoma, nasal type. Serum beta2-microglobulin (β2-M) was found to be a predictor in some subtypes of B-cell lymphoma. However, its prognostic significance in NK/T-cell lymphoma has never been explored. We retrospectively analyzed 82 patients newly diagnosed as UNKTL. Serum β2-M was detected prior to treatment in this series. Various statistical analyses were performed to evaluate the significance of the relevant clinical parameters. High serum β2-M level was calculated as ≥2.5 mg/L by the median value. The number of patients with serum β2-M ≥2.5 mg/L at diagnosis was 39 (47.6%) and 43 patients (52.4%) with β2-M <2.5 mg/L. Patients with high serum β2-M level at diagnosis seemed to have more adverse clinical features: B symptoms (p=0.007) and elevated LDH level (p<0.001), and high KPI score (p=0.002). Serum β2-M ≥2.5 mg/L was significantly associated with poor overall survival (5-year OS, 35.2% vs 73.6%; p=0.001) and progression-free survival (5-year PFS, 27.5% vs 55.9%; p=0.028). For patients with early stage, serum β2-M at diagnosis could also help to distinguish those with favorable outcomes from those with poor outcomes. In multivariate analysis, high serum β2-M level remained its prognostic impact on survival (OS: p=0.002; PFS: p=0.039), independent of the International Prognostic Index score. Our study suggested high serum β2-M was a novel predictor of prognosis in patients with UNKTL. A simply and regular way might be established to identify UNKTL patients of different risks at diagnosis.

摘要

上呼吸道和消化道自然杀伤(NK)/T 细胞淋巴瘤(UNKTCL)是结外 NK/T 细胞淋巴瘤,鼻型中最常见的类型。血清β2-微球蛋白(β2-M)已被发现是某些 B 细胞淋巴瘤亚型的预测因子。然而,其在 NK/T 细胞淋巴瘤中的预后意义尚未被探索。我们回顾性分析了 82 例新诊断为 UNKTCL 的患者。在本系列中,在治疗前检测了血清β2-M。通过中位数计算,将血清β2-M 水平高定义为≥2.5mg/L。诊断时血清β2-M≥2.5mg/L的患者有 39 例(47.6%),β2-M<2.5mg/L的患者有 43 例(52.4%)。诊断时血清β2-M 水平较高的患者似乎具有更多不良的临床特征:B 症状(p=0.007)和升高的 LDH 水平(p<0.001),以及较高的 KPI 评分(p=0.002)。血清β2-M≥2.5mg/L 与较差的总生存期(5 年 OS,35.2%vs73.6%;p=0.001)和无进展生存期(5 年 PFS,27.5%vs55.9%;p=0.028)显著相关。对于早期患者,诊断时的血清β2-M 也有助于区分预后良好和预后不良的患者。在多变量分析中,高血清β2-M 水平仍然是生存的预后因素(OS:p=0.002;PFS:p=0.039),独立于国际预后指数评分。我们的研究表明,高血清β2-M 是 UNKTCL 患者预后的新预测因子。可以建立一种简单且常规的方法,在诊断时识别不同风险的 UNKTCL 患者。

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