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组织病理学指标及神经影像学特征状态在原发性中枢神经系统弥漫性大B细胞淋巴瘤中的临床影响:一项对51例病例的单中心回顾性分析

Clinical Impact of the Histopathological Index and Neuroimaging Features Status in Primary Central Nervous System Diffuse Large B-Cell Lymphoma: A Single-Center Retrospective Analysis of 51 Cases.

作者信息

Qi Zhou, Duan Lei, Yuan Guoqiang, Liu Jianli, Li Jian, Li Guoqiang, Yu Yue, Xu Yanlong, Ma Shangxian, Pan Yawen, Zhang Yinian

机构信息

Department of Neurosurgery, Key Laboratory of Neurology, Gansu Province, Lanzhou University Second Hospital, Lanzhou, China.

Department of Medical Imaging, Lanzhou University Second Hospital, Lanzhou, China.

出版信息

Front Oncol. 2022 Jul 8;12:769895. doi: 10.3389/fonc.2022.769895. eCollection 2022.

Abstract

Primary central nervous system diffuse large B-cell lymphoma (PCNS-DLBCL) is an uncommon non-Hodgkin lymphoma subtype, and its clinical and pathological characteristics remain unclear. PCNS-DLBCL patient data were retrospectively evaluated to determine clinical and pathological characteristics and prognostic factors. Furthermore, prognoses were calculated by Kaplan-Meier and Cox regression models based on clinical observations. In total, 51 immunocompetent patients were enrolled. The median age was 55 (range, 16-82) years, and the male-to-female ratio was 3:2. Headache (n = 19; 37%) and the frontal lobe (n = 16; 31%) were the most common presenting symptom and location, respectively. The median follow-up was 33 (range, 3-86) months, and the median overall survival (OS) and progression-free survival (PFS) were 18 months [95% confidence interval (CI), 21.2-34.2] and 15 months (95% CI, 16.9-28.7), respectively. Ki-67, cluster of differentiation-3, and deep brain involvement were independent prognostic markers. Moreover, multifocal lesions and deep brain involvement were unfavorable independent prognostic markers for PFS. This study indicates that targeted drug development for adverse prognostic factors is possible and provides guidance for clinical treatment decision-making.

摘要

原发性中枢神经系统弥漫性大B细胞淋巴瘤(PCNS-DLBCL)是一种罕见的非霍奇金淋巴瘤亚型,其临床和病理特征尚不清楚。对PCNS-DLBCL患者的数据进行回顾性评估,以确定临床和病理特征及预后因素。此外,根据临床观察结果,采用Kaplan-Meier法和Cox回归模型计算预后。总共纳入了51例免疫功能正常的患者。中位年龄为55岁(范围16-82岁),男女比例为3:2。头痛(n = 19;37%)和额叶(n = 16;31%)分别是最常见的首发症状和部位。中位随访时间为33个月(范围3-86个月),中位总生存期(OS)和无进展生存期(PFS)分别为18个月[95%置信区间(CI),21.2-34.2]和15个月(95%CI,16.9-28.7)。Ki-67、分化簇3和深部脑受累是独立的预后标志物。此外,多灶性病变和深部脑受累是PFS的不良独立预后标志物。本研究表明,针对不良预后因素进行靶向药物开发是可行的,并为临床治疗决策提供指导。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/387a/9304881/5b9373fc67de/fonc-12-769895-g001.jpg

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