Analysis of clinical characteristics and establishment of a new prognostic model in 202 cases with peripheral T⁃cell lymphomas
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摘要:
目的：外周T细胞淋巴瘤(peripheral T-cell lymphomas，PTCL)是一组异质性的非霍奇金淋巴瘤，本研究旨在探索 PTCL患者的临床特征，寻找影响无进展生存期(progression-free survival，PFS)和总生存期(overall survival，OS)的新指标，建立新的预后模型。方法：回顾性分析2009年7月—2021年9月于南京医科大学第一附属医院就诊的202例PTCL患者的临床资料，采用Kaplan-Meier法、单因素和多因素Cox回归分析等进行生存分析和预后因素评估。结果：所有PTCL患者中位PFS与 OS分别为11个月和43个月。血红蛋白(hemoglobin，Hb)正常患者的中位PFS(44个月vs. 9个月，P ＜ 0.001)和中位OS(83个月 vs. 24个月，P=0.002)均优于Hb水平低于正常的患者。美国东部肿瘤协作组(Eastern Cooperative Oncology Group，ECOG)评分＞ 1(P=0.009)和Hb水平低于正常(P=0.007)是PFS的独立危险因素，年龄＞60岁(P=0.015)和ECOG评分＞1(P=0.002)是OS的独立危险因素。Hb 水平联合国际预后指数(international prognostic index，IPI)和 T 细胞淋巴瘤预后指数(prognostic index for T-cell lymphoma，PIT)评分提高了预测PFS的准确性。结论：Hb水平可以作为评估PTCL患者预后的指标，Hb水平联合IPI 和PIT可以提高预测PTCL患者预后的准确性。
Abstract:
Objective：Peripheral T -cell lymphomas(PTCL)is a heterogeneous group of non -Hodgkin’s lymphomas. The current study aims to analyze the clinical features of PTCL patients，and explore new factors that affected the progression-free survival(PFS) and overall survival(OS)，with which to establish new prognostic models. Methods：The clinical data of 202 patients with PTCL from the First Affiliated Hospital of Nanjing Medical University between July 2009 and September 2021 were retrospectively analyzed. Kaplan - Meier method，univariate and multivariate Cox regression analysis were performed for the survival analysis and prognostic factor evaluation. Results：The median PFS and OS of all PTCL patients were 11 months and 43 months respectively. Patients with lower level of hemoglobin(Hb)showed shorter PFS(9 months vs. 44 months，P ＜ 0.001)and OS(24 months vs. 83 months，P=0.002) than patients with normal level of Hb. The ECOG scores ＞1(P=0.009)and lower Hb level(P=0.007)were independent risk factors for PFS. Age ＞60 years(P=0.015)and the ECOG score ＞1(P=0.002)were independent risk factors for OS. International prognostic index (IPI)or prognostic index for T-cell lymphoma(PIT)combined with the Hb level improved the accuracy of predicting PFS of patients with PTCL. Conclusion：The level of Hb may be a good candidate for predicting prognosis of patients with PTCL. The Hb level combined with IPI and PIT can improve the ability to predict prognosis of patients with PTCL.
