[糖尿病和弥漫性大B细胞淋巴瘤（DLBCL）治疗期间高血糖对弥漫性大B细胞淋巴瘤患者的预后影响]
[The prognostic impact of diabetic mellitus and hyperglycemia during DLBCL treatment on patients with diffuse large B-cell lymphoma].
作者信息
Hu Y, Xu Y J, Li M Z, Lan Y X, Mao L, Ning Q Y, Xu W, Yang H L, Zhang Y Z
机构信息
Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin 300060, China State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, China.
Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin 300060, China.
出版信息
Zhonghua Xue Ye Xue Za Zhi. 2021 Feb 14;42(2):151-157. doi: 10.3760/cma.j.issn.0253-2727.2021.02.011.
This study aims to investigate the clinical features and prognostic factors of patients with diffuse large B-cell lymphoma (DLBCL) and assess the prognostic value of diabetes mellitus (DM) and hyperglycemia during DLBCL treatment in DLBCL. The clinical data of 481 newly diagnosed DLBCL patients from January 1, 2009 to December 31, 2019 at Tianjin Medical University Cancer Institute and Hospital and Sun Yat-sen University Cancer Center were retrospectively collected, focusing on their blood glucose levels before and during treatment. Cox regression method was used for univariate analysis to assess prognostic factors, and the Kaplan-Meier method was used to draw survival curves to assess the prognostic value of DM and hyperglycemia during DLBCL treatment in patients with DLBCL. Eighty-two (17.0%) patients had DM before DLBCL diagnosis and treatment, and 88 (18.3%) patients had at least one blood glucose increase during DLBCL treatment. Cox univariate analysis showed that age, Ann Arbor stage, international prognostic index, and DM were associated with overall survival (OS) and progression-free survival (PFS) (all <0.05) . The pairwise comparison between the two groups showed that the OS (=0.001) and PFS (<0.001) of patients with pre-existing DM were significantly worse than those of patients without abnormal blood glucose. Moreover, the OS (=0.003) and PFS (<0.001) of patients with hyperglycemia during DLBCL treatment were significantly worse than those of patients without abnormal blood glucose. No significant difference exists between patients with DM and patients with hyperglycemia during DLBCL treatment (OS, =0.557; PFS, =0.463) . Additionally, patients with adequate glycemic control during chemotherapy had a better prognosis compared with patients with poor glycemic control (OS, =0.037; PFS, =0.007) . DM is an important factor affecting the prognosis of patients with DLBCL. Moreover, hyperglycemia during treatment is related to the poor prognosis of patients with DLBCL.
本研究旨在探讨弥漫性大B细胞淋巴瘤（DLBCL）患者的临床特征和预后因素，并评估糖尿病（DM）及DLBCL治疗期间高血糖对DLBCL患者预后的影响。回顾性收集了2009年1月1日至2019年12月31日在天津医科大学肿瘤医院和中山大学肿瘤防治中心新诊断的481例DLBCL患者的临床资料，重点关注其治疗前及治疗期间的血糖水平。采用Cox回归方法进行单因素分析以评估预后因素，采用Kaplan-Meier法绘制生存曲线以评估DM及DLBCL治疗期间高血糖对DLBCL患者预后的影响。82例（17.0%）患者在DLBCL诊断和治疗前患有DM，88例（18.3%）患者在DLBCL治疗期间至少有一次血糖升高。Cox单因素分析显示，年龄、Ann Arbor分期、国际预后指数和DM与总生存期（OS）和无进展生存期（PFS）相关（均<0.05）。两组间的两两比较显示，既往有DM的患者的OS（=0.001）和PFS（<0.001）显著差于血糖正常的患者。此外，DLBCL治疗期间发生高血糖的患者的OS（=0.003）和PFS（<0.001）显著差于血糖正常的患者。DLBCL治疗期间患有DM的患者与发生高血糖的患者之间无显著差异（OS，=0.557；PFS，=0.463）。此外，化疗期间血糖控制良好的患者与血糖控制不佳的患者相比，预后更好（OS，=0.037；PFS，=0.007）。DM是影响DLBCL患者预后的重要因素。此外，治疗期间的高血糖与DLBCL患者的不良预后相关。
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