马淋巴瘤中球蛋白浓度与预后的关联

Association of globulin concentrations with prognosis in horses with lymphoma.

作者信息

Wensley Fiona M, Berryhill Emily H, Magdesian K Gary

机构信息

Department of Medicine and Epidemiology, University of California, Davis, Davis, CA, United States.

出版信息

Front Vet Sci. 2023 Jan 9;9:1086010. doi: 10.3389/fvets.2022.1086010. eCollection 2022.

DOI:10.3389/fvets.2022.1086010

PMID:36699338

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9868912/

Abstract

INTRODUCTION

Lymphoma is the most common hemopoietic neoplasia in horses. Common clinicopathologic abnormalities in equine lymphoma include hyperglobulinemia, hypoalbuminemia, hyperfibrinogenemia, anemia, thrombocytopenia and lymphocytosis. Hypoglobulinemia has been reported in other species with lymphoma, however it has not been well-described in horses. The objectives of this study were to examine the prevalence of hypoglobulinemia in equine lymphoma, and to identify prognosis and clinicopathological abnormalities associated with serum globulin concentrations.

METHODS

Ninety-six horses with lymphoma were investigated in this retrospective study. Patients were allocated into groups based on serum globulin concentration. Survival analysis was performed to determine risk factors associated with globulin concentration and outcome.

RESULTS

Nineteen horses were hypoglobulinemic (≤2.1 g/dL), 63/98 were normoglobulinemic (2.2-4.3 g/dL), and 16/98 were hyperglobulinemic (≥4.4 g/dL). Hyperglobulinemia was associated with a higher anion gap ( = 0.0005), lower bicarbonate ( = 0.006), sodium ( = 0.03) and chloride concentrations ( = 0.002), and higher total protein than hypoglobulinemic horses ( < 0.0001). For location, 37% of horses with mucocutaneous lymphoma were hypoglobulinemic, compared to none in the hyperglobulinemic group ( = 0.02). Survival times were significantly different between low, normal and high globulin groups ( = 0.0002, median [range] survival times: 333 [1-3792], 43 [1-4,001] and 4 [1-129] days, respectively). Significant risk factors for shortened time to death were hyperglobulinemia (HR 2.4, = 0.02), T cell lymphoma (HR 3.5, < 0.0001), and multicentric (HR 3.1, = 0.0008) and mediastinal (HR 6.4, = 0.006) forms of lymphoma. Lack of chemotherapy was associated with shortened survival time (HR 4.5, P < 0.0001). B cell lymphomas ( < 0.0001) and mucocutaneous lymphoma location ( < 0.0001) were associated with longer survival times.

DISCUSSION

Serum globulin concentrations are associated with location of lymphoma, clinicopathologic abnormalities, and survival times in equine lymphoma.

摘要

引言

淋巴瘤是马最常见的造血系统肿瘤。马淋巴瘤常见的临床病理异常包括球蛋白血症、低白蛋白血症、高纤维蛋白原血症、贫血、血小板减少和淋巴细胞增多。在其他患有淋巴瘤的物种中曾有低球蛋白血症的报道，但在马中尚未得到充分描述。本研究的目的是调查马淋巴瘤中低球蛋白血症的患病率，并确定与血清球蛋白浓度相关的预后及临床病理异常。

方法

本回顾性研究对96匹患有淋巴瘤的马进行了调查。根据血清球蛋白浓度将患者分组。进行生存分析以确定与球蛋白浓度和预后相关的危险因素。

结果

19匹马存在低球蛋白血症（≤2.1 g/dL），63/98匹马球蛋白水平正常（2.2 - 4.3 g/dL），16/98匹马存在高球蛋白血症（≥4.4 g/dL）。与低球蛋白血症的马相比，高球蛋白血症与较高的阴离子间隙（P = 0.0005）、较低的碳酸氢盐（P = 0.006）、钠（P = 0.03）和氯浓度（P = 0.002）以及较高的总蛋白相关（P < 0.0001）。就淋巴瘤位置而言，37%的皮肤黏膜淋巴瘤马存在低球蛋白血症，而高球蛋白血症组中无一例（P = 0.02）。低、正常和高球蛋白组的生存时间有显著差异（P = 0.0002，中位[范围]生存时间：分别为333[1 - 3792]、43[1 - 4001]和4[1 - 129]天）。缩短死亡时间的显著危险因素包括高球蛋白血症（风险比2.4，P = 0.02）、T细胞淋巴瘤（风险比3.5，P < 0.0001）以及多中心（风险比3.1，P = 0.0008）和纵隔（风险比6.4，P = 0.006）型淋巴瘤。未进行化疗与生存时间缩短相关（风险比4.5，P < 0.0001）。B细胞淋巴瘤（P < 0.0001）和皮肤黏膜淋巴瘤位置（P < 0.0001）与较长的生存时间相关。