Shen Hanying, Jiang Lingling, Nie Linlin, Fan Xiaohui, Xu Yanqiu, Yin Lingling, Xu Linyan, Xia Jieyun, Li Zhenyu, Zhu Feng, Xu Kailin
Blood Disease Institute, Xuzhou Medical University, Xuzhou, Jiangsu, 221000, People's Republic of China.
Department of Hematology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, 221002, People's Republic of China.
Cancer Manag Res. 2021 Mar 2;13:2171-2180. doi: 10.2147/CMAR.S299745. eCollection 2021.
Originating from extranodal organs or tissues, primary extranodal lymphoma (PENL) acts in different primary sites with diverse clinical performances and PENL has remarkable geographical differences and lacks the relevant reports in each region.
Two hundred and twenty PENL patients were enrolled, and the relevant clinical and laboratory indicators were analyzed. In addition, statistical methods were applied to analyze the effects of different factors on overall survival (OS) and progression-free survival (PFS) of patients.
The three most frequent primary sites of PENL are the digestive system, head and neck, and central nervous system. The patients were classified into groups based on their risk status, resulting in low-risk, medium-low-risk, medium-high-risk, and high-risk, and their respective 3-year OS values were calculated, which showed that 121 patients (55%) were in the low-risk group and 3-year OS was 85.2% (25.9% medium-low-risk, 3-year OS 66.6%; 15% medium-high-risk, 3-year OS 61.9%; 4.09% high risk, 3-year OS 45.7%). A multivariate analysis of the Cox regression demonstrated that serum beta 2-microglobulin (β-MG) and lactate dehydrogenase (LDH) were independent prognostic factors for OS and PFS, respectively. Both the performance status and pathological subtypes were independent prognostic factors for OS and PFS.
The correlated independent risk factors such as β-MG, LDH, performance status, and pathological subtypes, were helpful for effectively determining the prognosis of PENL patients and guiding treatment.
原发性结外淋巴瘤（PENL）起源于结外器官或组织，在不同的原发部位表现各异，具有显著的地域差异，且各地区缺乏相关报道。
纳入220例PENL患者，分析相关临床和实验室指标。此外，应用统计学方法分析不同因素对患者总生存期（OS）和无进展生存期（PFS）的影响。
PENL最常见的三个原发部位是消化系统、头颈部和中枢神经系统。根据患者的风险状态进行分组，分为低风险、中低风险、中高风险和高风险组，并计算各自的3年OS值，结果显示121例患者（55%）处于低风险组，3年OS为85.2%（中低风险组25.9%，3年OS为66.6%；中高风险组15%，3年OS为61.9%；高风险组4.09%，3年OS为45.7%）。Cox回归多因素分析表明，血清β2-微球蛋白（β-MG）和乳酸脱氢酶（LDH）分别是OS和PFS的独立预后因素。体能状态和病理亚型均是OS和PFS的独立预后因素。
β-MG、LDH、体能状态和病理亚型等相关独立危险因素有助于有效判断PENL患者的预后并指导治疗。
