[外周血红蛋白与红细胞分布宽度比值对弥漫性大B细胞淋巴瘤患者预后的影响]

[Influence of the Ratio of Peripheral Hemoglobin-to-Red Cell Distribution width on the Prognosis of Patients with Diffuse Large B-cell Lymphoma].

作者信息

Dong Xue-Yan, Tang Guo-Feng, Chen Wei, Cao Jiang, Cheng Hai, Li Zhen-Yu, Xu Kai-Lin

机构信息

Department of Hematology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou 221002, Jiangsu Province, China.

Department of Hematology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou 221002, Jiangsu Province, China,E-mail:

出版信息

Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2022 Jun;30(3):765-770. doi: 10.19746/j.cnki.issn.1009-2137.2022.03.017.

DOI:10.19746/j.cnki.issn.1009-2137.2022.03.017

PMID:35680803

Abstract

OBJECTIVE

To investigate the influence of peripheral hemoglobin (Hb)-to-red cell distribution width (RDW) ratio (HRR) on the prognosis of patients with diffuse large B-cell lymphoma (DLBCL).

METHODS

Data of 265 patients with diffuse large B-cell lymphoma (DLBCL) at the Affiliated Hospital of Xuzhou Medical University from January 2014 to December 2019 were retrospectively analyzed. 132 healthy people in the same period were used as normal control group. The best cut-off points of HRR was determined by receiver operating characteristics (ROC) curve; the chi-square test was used to analyze the correlation of clinical characteristics with HRR; the Kaplan-Meier method was used to compare the overall survival (OS) and progression-free survival (PFS) of HRR patients in different groups; the Cox proportional risk model was used for univariate and multivariate analysis.

RESULTS

The best cut-off value of HRR was 0.936, which was divided into low HRR group and high HRR group. The low HRR group had a higher ECOG score, higher incidence of advanced Ann Arbor stage, higher NCCN-IPI score, and elevated LDH level. K-M survival analysis showed that OS (P<0.001) and PFS (P<0.001) in the low HRR group were significantly shorter than that in the higher HRR group. The multivariate analysis revealed that HRR was an independent predictor of OS（HR＝0.379，95％CI：0.237-0.605，P<0.001） and PFS （HR＝0.384，95％CI：0.241－0.614，P<0.001） in DLBCL patients.

CONCLUSION

Low HRR（<0.936） in patients with DLBCL indicates a poor prognosis, which is an independent prognosis risk factor.

摘要

目的

探讨外周血红蛋白（Hb）与红细胞分布宽度（RDW）比值（HRR）对弥漫性大B细胞淋巴瘤（DLBCL）患者预后的影响。

方法

回顾性分析2014年1月至2019年12月徐州医科大学附属医院265例弥漫性大B细胞淋巴瘤（DLBCL）患者的数据。同期132例健康人作为正常对照组。通过受试者工作特征（ROC）曲线确定HRR的最佳截断点；采用卡方检验分析临床特征与HRR的相关性；采用Kaplan-Meier法比较不同组HRR患者的总生存期（OS）和无进展生存期（PFS）；采用Cox比例风险模型进行单因素和多因素分析。

结果

HRR的最佳截断值为0.936，分为低HRR组和高HRR组。低HRR组ECOG评分较高，晚期Ann Arbor分期发生率较高，NCCN-IPI评分较高，乳酸脱氢酶（LDH）水平升高。K-M生存分析显示，低HRR组的OS（P<0.001）和PFS（P<0.001）明显短于高HRR组。多因素分析显示，HRR是DLBCL患者OS（HR＝0.379，95％CI：0.237-0.605，P<0.001）和PFS（HR＝0.384，95％CI：0.241－0.614，P<0.001）的独立预测因素。