文章摘要
袁颖莹,王 莉,朱华渊,范 磊,徐 卫.51例滤泡淋巴瘤3A级与3B级患者的临床特征及预后分析[J].南京医科大学学报,2018,(8):1118~1123
51例滤泡淋巴瘤3A级与3B级患者的临床特征及预后分析
A retrospective analysis of clinical characteristics and prognostic factors for 51 cases of follicular lymphoma grade 3A and grade 3B
投稿时间:2018-02-27  
DOI:10.7655/NYDXBNS20180820
中文关键词: 滤泡淋巴瘤  滤泡淋巴瘤3A级  滤泡淋巴瘤3B级  预后
英文关键词: follicular lymphoma  follicular lymphoma grade 3A  follicular lymphoma grade 3B  prognosis
基金项目:国家自然科学基金(81770166)
作者单位
袁颖莹 南京医科大学第一附属医院血液科江苏 南京 210029 
王 莉 南京医科大学第一附属医院血液科江苏 南京 210029 
朱华渊 南京医科大学第一附属医院血液科江苏 南京 210029 
范 磊 南京医科大学第一附属医院血液科江苏 南京 210029 
徐 卫 南京医科大学第一附属医院血液科江苏 南京 210029 
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中文摘要:
      目的:探讨滤泡淋巴瘤(follicular lymphoma,FL)3A级与FL 3B级的临床生物学特征、对治疗的反应以及预后差异。方法:收集51例初诊FL 3级患者的临床资料,分析临床特征和预后差异。结果:51例FL 3级患者包括FL 3A级34例(67%)、FL 3B级17例(33%),其中20例合并弥漫大B细胞淋巴瘤(diffuse large B cell lymphoma,DLBCL)成分。FL 3B级合并DLBCL患者的比例显著高于FL 3A级。相关性分析显示:FL 3A级和BCL2阳性(P=0.046)表达显著相关,而FL 3B级则与MUM1阳性表达(P=0.002)和较早的Ann?Abor分期(P=0.046)显著相关。经含利妥昔单抗方案的一线化疗,2组患者对治疗的反应无显著差异。生存分析显示FL 3B级是FL 3级患者的无进展生存期(progression free survival,PFS)的独立危险因素(P=0.048,HR=3.271,95% CI:1.012~10.573),但对总生存期(overall survival,OS)无显著影响。FL 3级合并DLBCL具有较短的PFS(P=0.003)和OS(P=0.04),且合并DLBCL是影响FL 3级患者PFS和OS的独立危险因素(PFS:P=0.012,HR=4.291,95%CI:1.373~13.405;OS:P=0.013,HR=2.392,95%CI:1.199~4.771)。结论:FL 3A级和FL 3B级在临床生物学特征和预后上存在显著差异。FL 3B级患者具有较短的PFS。FL 3级合并DLBCL提示预后不良。
英文摘要:
      Objective:The aim of this study was to analyze the clinical characteristics,treatment response and outcomes of follicular lymphoma(FL)grade 3A and grade 3B. Methods:Data of 51 patients,diagnosed as FL grade 3,were collected. Statistical analysis was performed to analyse the differences in clinical characteristics and outcomes. Results:Out of 51 FL3 cases,including FL3A in 34 cases(67%)and FL3B in 17 cases(33%),20 cases had diffuse large B cell lymphoma(DLBCL)component. The percentage of FL3B patients with DLBCL component was significantly higher than that of FL3A patients. Correlation analyses showed that FL3A was significantly associated with BCL2 positive expression(P=0.046),whereas FL3B was significantly associated with MUM1 positive expression(P=0.002)and early Ann?Abor staging(P=0.046). All patients received first?line immunochemotherapy includes rituximab and chemotherapy. There was no significant difference between the two groups in response to treatment. Survival analyses showed that FL3B was an independent risk factor for progression free survival(PFS)in FL3 patients(P=0.048,HR=3.271,95% CI:1.012~10.573). However,there was no significant difference between the two groups in terms of overall survival(OS). FL3 co?existence with DLBCL component predicted shorter PFS(P=0.003)and OS(P=0.04). The co?existence of DLBCL component was an independent prognostic factor for PFS and OS in FL3 patients(PFS:P=0.012,HR=4.291,95% CI:1.373~13.405;OS:P=0.013,HR=2.392,95% CI:1.199~4.771). Conclusion:FL3A and FL3B had significant differences in clinical characteristics and outcomes. FL3B patients had shorter PFS. Moreover,FL3 coexistence with DLBCL component suggested poor prognosis.
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