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幽门螺杆菌感染对胃弥漫性大 B 细胞淋巴瘤的预后意义。

Prognostic significance of helicobacter pylori-infection in gastric diffuse large B-cell lymphoma.

机构信息

State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University and Collaborative Innovation Center, Chengdu, People's Republic of China.

出版信息

BMC Cancer. 2019 Aug 28;19(1):842. doi: 10.1186/s12885-019-6067-5.

Abstract

BACKGROUND

Helicobacter pylori (H. pylori) is thought to have an oncogenic effect on the development of gastric malignancies. However, the effect of H. pylori status on the prognosis of gastric diffuse large B-cell lymphoma (DLBCL) remains unconfirmed. This study aimed to identify the prognostic importance of H. pylori infection in de novo gastric DLBCL.

METHODS

One hundred and twenty-nine patients diagnosed with primary de novo gastric DLBCL at the West China Hospital of Sichuan University from 1st January 2009 to 31st May 2016 were included. The clinical features of the patients were documented. H. pylori status was assessed via urease breath tests and histologic examinations. The prognostic value of H. pylori was verified via univariate and multivariate analyses.

RESULTS

Over a median follow-up of 52.2 months (range 4-116), the 5-year overall survival (OS) for all patients was 78.7%. Patients with H. pylori infections had significantly better 5-year PFS and OS than did the H. pylori-negative subgroup (5-year PFS, 89.3% vs. 74.1%, P = 0.040; 5-year OS, 89.7% vs. 71.8%, P = 0.033). Negative H. pylori status and poor ECOG performance were independent negative prognostic indicators for both PFS and OS (PFS, P = 0.045 and P = 0.001, respectively; OS, P = 0.021 and P < 0.001, respectively).

CONCLUSIONS

H. pylori status in de novo gastric DLBCL can be a promising predictor of disease outcome, and patients with negative H. pylori status require careful follow-up since they tend to have a worse outlook.

摘要

背景

幽门螺杆菌(H. pylori)被认为对胃恶性肿瘤的发展具有致癌作用。然而,H. pylori 状态对胃弥漫性大 B 细胞淋巴瘤(DLBCL)的预后影响仍未得到证实。本研究旨在确定 H. pylori 感染对初发胃 DLBCL 的预后意义。

方法

纳入 2009 年 1 月 1 日至 2016 年 5 月 31 日在四川大学华西医院诊断为原发性初发胃 DLBCL 的 129 例患者。记录患者的临床特征。通过尿素酶呼气试验和组织学检查评估 H. pylori 状态。通过单因素和多因素分析验证 H. pylori 的预后价值。

结果

在中位随访 52.2 个月(范围 4-116)期间,所有患者的 5 年总生存率(OS)为 78.7%。H. pylori 感染患者的 5 年无进展生存率(PFS)和 OS 明显优于 H. pylori 阴性亚组(5 年 PFS,89.3% vs. 74.1%,P=0.040;5 年 OS,89.7% vs. 71.8%,P=0.033)。H. pylori 状态阴性和 ECOG 表现差是 PFS 和 OS 的独立不良预后因素(PFS,P=0.045 和 P=0.001;OS,P=0.021 和 P<0.001)。

结论

初发胃 DLBCL 中的 H. pylori 状态可以成为疾病结局的有前途的预测指标,H. pylori 状态阴性的患者需要密切随访,因为他们的预后往往较差。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7f50/6712724/957615bfc476/12885_2019_6067_Fig1_HTML.jpg

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