Suki S, Swan F, Tucker S, Fritsche H A, Redman J R, Rodriguez M A, McLaughlin P, Romaguera J, Hagemeister F B, Velasquez W S
Division of Medicine, University of Texas M. D. Anderson Cancer Center, Houston 77030, USA.
Leuk Lymphoma. 1995 Jun;18(1-2):87-92. doi: 10.3109/10428199509064927.
We have previously proposed a staging system for large cell lymphoma using the two serum markers beta-2-microglobulin (B2M) and lactate dehydrogenase (LDH). We recently tested this model in a different cohort of patients with large cell lymphoma and also examined the possible contribution of thymidine kinase (TK), a previously reported serologic prognostic factor. Using an inclusion criteria in the multivariate analysis for both forward and backward selection of p < 0.15, only LDH, B2M, and TK were significant independent prognostic factors for both time to treatment failure (TTF) and survival. Inclusion of TK in the serologic model resulted in three significantly different risk groups for both TTF and survival. Corresponding endpoints at three years were: 1) good risk (no markers elevated, n = 43): 78%, 91%; 2) intermediate risk (1 or 2 markers elevated, n = 47): 41%, 36%; 3) poor risk (3 markers elevated, n = 11): 0%, 0%. This analysis extends the observation of the independent prognostic significance of B2M and LDH. The addition of TK permits a more precise estimate of risk, contributing to the utility of a serological staging system for large cell lymphoma.
我们之前曾提出一种使用两种血清标志物β-2-微球蛋白（B2M）和乳酸脱氢酶（LDH）的大细胞淋巴瘤分期系统。我们最近在另一组大细胞淋巴瘤患者中对该模型进行了测试，并研究了胸苷激酶（TK）这一先前报道的血清学预后因素的可能作用。在多变量分析中，使用向前和向后选择时p < 0.15的纳入标准，对于治疗失败时间（TTF）和生存率而言，只有LDH、B2M和TK是显著的独立预后因素。将TK纳入血清学模型后，对于TTF和生存率而言，产生了三个显著不同的风险组。三年时相应的终点情况如下：1）低风险（无标志物升高，n = 43）：78%，91%；2）中风险（1或2种标志物升高，n = 47）：41%，36%；3）高风险（3种标志物升高，n = 11）：0%，0%。该分析扩展了对B2M和LDH独立预后意义的观察。TK的加入使风险估计更为精确，有助于大细胞淋巴瘤血清学分期系统的应用。
