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南京医科大学学报(自然科学版) 第43卷第4期
·518 · Journal of Nanjing Medical University(Natural Sciences) 2023年4月
·临床研究·
血小板⁃淋巴细胞比率在原发性中枢神经系统淋巴瘤患者中的
预后意义
郭婧冉,杜凯欣,梁金花,吴佳竹,王 莉,徐 卫 *
南京医科大学第一附属医院血液科,江苏 南京 210029
[摘 要] 目的:探讨血小板⁃淋巴细胞比值(platelet⁃lymphocyte ratio,PLR)在原发性中枢神经系统淋巴瘤(primary central ner⁃
vous 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 Extranod⁃
al 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:PCNSL 患者的中位无进展生存期(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PCNSL 患者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。
[关键词] 原发中枢神经系统淋巴瘤;血小板⁃淋巴细胞比值;真实世界研究;预后;生存
[中图分类号] R733.4 [文献标志码] A [文章编号] 1007⁃4368(2023)04⁃518⁃08
doi:10.7655/NYDXBNS20230410
The prognostic implication of the platelet⁃lymphocyte ratio in patients with primary central
nervous system lymphoma
GUO Jingran,DU Kaixin,LIANG Jinhua,WU Jiazhu,WANG Li,XU Wei *
Department of Hematology,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China
[Abstract] Objective:To explore the prognostic implication 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 between June 2011 and
December 2021 were retrospectively analyzed. Kaplan ⁃ Meier method,univariate and multivariate Cox regression analyses were
performed for survival analysis and prognostic factors evaluation. Results:Median progression⁃free survival(PFS)and overall survival
(OS)were 17 months and 39 months in PCNSL patients,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≥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 of PCNSL patients. Conclusion:PLR may be used as an indicator to evaluate the prognosis of PCNSL.
[Key words] primary central nervous system lymphoma;PLR;real⁃world study;diagnosis;prognosis
[J Nanjing Med Univ,2023,43(04):518⁃524,541]
[基金项目] 国家自然科学基金(81770166)
∗
通信作者(Corresponding author),E⁃mail:xuwei10000@hotmail.com