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原发性胃弥漫性大 B 细胞淋巴瘤:免疫肿瘤治疗时代的预后因素。

Primary Gastric Diffuse Large B-Cell Lymphoma: Prognostic Factors in the Immuno-Oncology Therapeutics Era.

机构信息

Shanxi Medical University, Taiyuan, Shanxi, China

Department of Hematology, Shanxi Tumor Hospital affiliated to Shanxi Medical University, Taiyuan, Shanxi, China

出版信息

Turk J Haematol. 2020 Aug 28;37(3):193-202. doi: 10.4274/tjh.galenos.2020.2019.0332. Epub 2020 Mar 12.

Abstract

OBJECTIVE

This study aimed to explore the prognostic factors for primary gastric diffuse large B-cell lymphoma (PG-DLBCL).

MATERIALS AND METHODS

This retrospective study analyzed 72 PG-DLBCL patients between January 2012 and December 2017 in the Shanxi Cancer Hospital of Shanxi Medical University to identify the different prognostic factors in PG-DLBCL. The clinical features, treatment, and follow-up information were analyzed.

RESULTS

The low CD4:CD8 ratio group (median subsequent overall survival [OS]: 36.06 months; 95% confidence interval [CI]: 25.73-46.40) showed a significant decrease in subsequent OS compared to the normal group among PG-DLBCL patients who were newly diagnosed and did not receive rituximab (median OS: 52.58 months; 95% CI: 44.18-60.97; p=0.029). Event-free survival status 24 months after the date of diagnosis (EFS24) also decreased significantly in the low CD4:CD8 group (median EFS24: 16.27 months; 95% CI: 13.09-19.45) compared to the normal group (median EFS24: 20.34 months; 95% CI: 17.05-23.63; p=0.014). Multivariate analysis showed that low CD4:CD8 at diagnosis was an independent poor prognostic factor for subsequent OS and EFS24.

CONCLUSION

Our data suggest that identifying prognostic factors, especially host immunity, may provide useful information for assessing prognosis or clinical management.

摘要

目的

本研究旨在探讨原发性胃弥漫大 B 细胞淋巴瘤(PG-DLBCL)的预后因素。

材料与方法

本回顾性研究分析了山西医科大学山西肿瘤医院 2012 年 1 月至 2017 年 12 月间 72 例 PG-DLBCL 患者,以确定 PG-DLBCL 不同的预后因素。分析了患者的临床特征、治疗和随访信息。

结果

在未接受利妥昔单抗治疗的初诊 PG-DLBCL 患者中,低 CD4:CD8 比值组(中位后续总生存期[OS]:36.06 个月;95%置信区间[CI]:25.73-46.40)的后续 OS 明显低于正常组(中位 OS:52.58 个月;95%CI:44.18-60.97;p=0.029)。诊断后 24 个月的无事件生存状态(EFS24)在低 CD4:CD8 组也明显降低(中位 EFS24:16.27 个月;95%CI:13.09-19.45),低于正常组(中位 EFS24:20.34 个月;95%CI:17.05-23.63;p=0.014)。多变量分析显示,初诊时的低 CD4:CD8 比值是后续 OS 和 EFS24 的独立不良预后因素。

结论

我们的数据表明,识别预后因素,尤其是宿主免疫,可能为评估预后或临床管理提供有用的信息。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4474/7463217/bc5a2d036a5a/TJH-37-193-g1.jpg

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