血小板-淋巴细胞比率(PLR)在原发性中枢神经系统淋巴瘤患者中的预后作用
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南京医科大学第一附属医院,江苏省人民医院

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The prognostic role of the platelet-lymphocyte ratio (PLR) in patients with primary CNS lymphoma
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    摘要:

    目的:探讨血小板-淋巴细胞比率(platelet-lymphocyte ratio,PLR)在原发性中枢神经系统淋巴瘤(primary central nervous system lymphoma,PCNSL)中的预后作用,寻找适合亚洲PCNSL人群的改良国际结外淋巴瘤研究组(International Extranodal Lymphoma Study Group,IELSG)评分系统。方法:回顾性分析2011年6月—2021年12月于南京医科大学第一附属医院就诊的72例原发中枢神经系统弥漫大B细胞淋巴瘤(diffuse large B-cell lymphoma,DLBCL)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:中位无进展生存期(progression-free survival,PFS)和总生存期(overall survival,OS)分别为17个月和39个月。单因素Cox回归分析证实PLR≥107(P=0.022,P=0.038),年龄≥54岁(P=0.043,P=0.027),乳酸脱氢酶(lactate dehydrogenase,LDH)/参考值正常上限(upper limit of normal value,ULN)>2(P=0.080,P=0.064),脑脊液(cerebro-spinal fluid,CSF)蛋白/ULN>2(P=0.051,P=0.023),美国东部肿瘤协作组体能状态(Eastern Cooperative Oncology Group performance status,ECOG)评分≥2(P=0.029,P=0.027)和改良IELSG高危组(P=0.064,P=0.001)与较短的PFS和OS有关。多因素Cox回归分析证实PLR≥107(P=0.011,P=0.022)和ECOG评分≥2(P=0.013,P=0.015)是PFS和OS的独立危险因素。 结论:PLR或可以作为一项评估PCNSL预后的指标。

    Abstract:

    To investigate the prognostic role of the platelet-lymphocyte ratio (PLR) in primary central nervous system lymphoma (PCNSL) and to find a modified IELSG scoring system suitable for the Asian PCNSL population. Methods:The clinical data of 72 patients with PCNSL from the First Affiliated Hospital of Nanjing Medical University from June 2011 to December 2021 were retrospectively analyzed. We also performed Kaplan-Meier method, univariate and multivariate Cox regression analysis for survival analysis and prognostic factors evaluation. Results: Median progression-free survival (PFS) and overall survival (OS) were 17 months and 39 months, respectively. Univariate Cox regression analysis confirmed PLR ≥107 (P=0.022, P=0.038), age 54≥ years (P=0.043,P=0.027), LDH/ULN>2(P=0.080,P=0.064), CSF protein/ULN>2 (P=0.051,P=0.023), ECOG评分≥2 ((P=0.029,P=0.027)) and modified IELSG high-risk group ((P=0.064,P=0.001) were associated with shorter PFS and OS. Multivariate Cox regression analysis confirmed PLR ≥107 (P=0.011, P=0.022) and ECOG≥2 (P=0.013, P=0.015) were independent risk factors for PFS and OS. Conclusion: PLR may be used as an indicator to evaluate the prognosis of PCNSL.

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  • 收稿日期:2022-10-14
  • 最后修改日期:2023-02-27
  • 录用日期:2023-04-17
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