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目的 T 细胞性非霍奇金淋巴瘤(T-NHL)是一组异质性疾病,恶性度高,疗效差,在我国相对高发,目前尚无有效的预后指标可以用来预见其治疗效果。本研究回顾性分析103例 T-NHL的临床特征与预后的关系。方法收集1998年12月至2004年12月在中山大学肿瘤防治中心确诊、有完整临床资料的 T-NHL,所有病例按照 WHO 2001淋巴瘤分类标准进行病理分型,并对临床资料进行分析,总结其与预后的关系。结果 103例患者中位年龄35(2～78)岁,男68例,女35例,中位生存时间24.1(0.8～84)个月,5年总生存率24.3%(25/103),其中25例(24.3%)采用放、化联合治疗,70例(68.0%)采用单纯化疗,3例采用单纯放疗,5例在获得完全缓解后进行造血干细胞移植。单因素生存分析年龄≥60岁、晚期病例(Ⅲ、Ⅳ)、结外侵犯、巨大包块、B 症状、体质状况(PS)≥2,LDH 升高、低白蛋白血症、高危国际预后指数(IPI)(IPI≥2)与预后不良有关,但是多因素分析证实年龄≥60岁、低蛋白血症、PS≥2是独立的预后不良因素。结论本研究证实了年龄、血清白蛋白水平、PS 是 T-NHL 的独立预后因素。
Objective T-cell non-Hodgkin’s lymphoma (T-NHL) is a group of heterogeneous diseases with high malignancy, poor curative effect and relatively high incidence in our country. There is no effective prognostic indicator for predicting its therapeutic effect. This study retrospectively analyzed the relationship between 103 clinical features and prognosis of T-NHL. Methods T-NHL was collected from December 1998 to December 2004 at the Cancer Center of Sun Yat-sen University with complete clinical data. All cases were classified according to WHO 2001 classification criteria of lymphoma, and the clinical data were analyzed and summarized Its relationship with prognosis. Results The median age was 35 (2-78) years old in 103 patients, including 68 males and 35 females, with a median survival time of 24.1 (0.8-84) months and a 5-year overall survival rate of 24.3% (25/103) 25 cases (24.3%) were treated with radiotherapy and chemotherapy, 70 cases (68.0%) were treated with chemotherapy alone, 3 cases received radiotherapy alone and 5 cases received complete remission after hematopoietic stem cell transplantation. Univariate analysis of survival ≥60 years of age, advanced cases (Ⅲ, Ⅳ), extranodal invasion, massive mass, B symptoms, physical condition (PS) ≥ 2, elevated LDH, hypoalbuminemia, high-risk international prognostic index (IPI≥2) is associated with poor prognosis, but multivariate analysis confirmed that age ≥60 years, hypoproteinemia, PS≥2 is an independent prognostic factor. Conclusion This study confirms the age, serum albumin levels and PS is an independent prognostic factor for T-NHL.