中国癌症杂志 ›› 2017, Vol. 27 ›› Issue (5): 376-382.doi: 10.19401/j.cnki.1007-3639.2017.05.009

• 论著 • 上一篇    下一篇

外周血绝对单核细胞计数、血小板与绝对淋巴细胞计数比值在原发鼻腔NK/T细胞淋巴瘤中的预后分析

陈亚芳,臧 立,张小影,赵 盼,袁 英,岳智杰,杨洪亮,赵海丰,于 泳,王亚非,赵智刚,张翼鷟,王晓芳   

  1. 天津医科大学肿瘤医院血液科,国家肿瘤临床医学研究中心,天津市“肿瘤防治”重点实
    验室,天津市恶性肿瘤临床医学研究中心,天津 300060
  • 出版日期:2017-05-30 发布日期:2017-06-14
  • 通信作者: 王晓芳 E-mail:xiaofangwang2005@163.com
  • 基金资助:
    国家自然科学基金(81272562)。

Prognostic significance of peripheral absolute monocyte count, platelet-lymphocyte ratio in patients with primary nasal natural killer/T-cell lymphoma

CHEN Yafang, ZANG Li, ZHANG Xiaoying, ZHAO Pan, YUAN Ying, YUE Zhijie, YANG Hongliang, ZHAO Haifeng, YU Yong,WANG Yafei, ZHAO Zhigang, ZHANG Yizhuo, WANG Xiaofang   

  1. Department of Hematology, Tianjin Medical University Cancer Institute and Hospital; National Clinical Research Center for Cancer; Key Laboratory of Cancer Prevention and Therapy, Tianjin; Tianjin’s Clinical Research Center for Cancer, Tianjin 300060, China
  • Published:2017-05-30 Online:2017-06-14
  • Contact: WANG Xiaofang E-mail: xiaofangwang2005@163.com

摘要: 背景与目的:NK/T细胞淋巴瘤(natural killer/T-cell lymphoma,NKTCL)为恶性淋巴瘤中较少见的一种类型,其在临床表现及整体疗效上差别较大,目前尚无确切的危险分层指导预后。该研究旨在探索治疗前外周血绝对单核细胞计数(absolute monocyte count,AMC)、血小板与绝对淋巴细胞计数比值(platelet-lymphocyte ratio,PLR)在原发鼻腔NKTCL预后中的意义,为患者提供更确切的危险分层,从而选择恰当的治疗方案改善预后。方法:收集天津医科大学肿瘤医院2008年1月—2013年12月初诊的132例原发鼻腔NKTCL患者的临床资料。回顾性分析治疗前外周血AMC、PLR与患者5年总生存率(overall survival,OS)及无进展生存率(progression-free survival,PFS)之间的关系。患者预后的影响因素采用单因素分析和Cox比例风险模型多因素分析。结果:治疗前外周血AMC、PLR在原发鼻腔NKTCL患者的预后分层中均具有重要作用。AMC小于0.5×109个/L组患者的预后明显优于AMC大于等于0.5×109个/L组,PLR小于150组患者的预后优于PLR大于等于150组(P<0.05)。根据分期、ECOG评分标准、AMC、PLR这4个独立危险因素,我们试图建立了一个新的预后模式,将所有患者分为3个不同危险组,结果发现3个组的5年OS及PFS差异有统计学意义(P<0.05)。结论:外周血AMC、PLR与原发鼻腔NKTCL患者的预后明显相关。由分期、ECOG评分标准、AMC、PLR这4个独立危险因素组成的新的预后模式可能较国际预后指数(International Prognostic Index,IPI)及韩国预后指数(Korean Prognostic Index,KPI)更确切方便、更经济实用。

关键词: 原发鼻腔NK/T细胞淋巴瘤, 绝对单核细胞计数, 血小板与绝对淋巴细胞计数比值, 总生存率, 无进展生存率

Abstract: Background and purpose: Natural killer/T-cell lymphoma (NKTCL) is a scarce subtype of malignant lymphoma, and it has heterogeneous clinical manifestation and treatment effect. Currently, no precise risk stratification is used to guide prognosis. This study aimed to evaluate the prognostic impact of pre-treatment peripheral blood absolute monocyte count (AMC) and platelet-lymphocyte ratio (PLR) in patients with primary nasal NKTCL, and provide more precise information for better risk stratification to select appropriate treatment and improve survival. Methods: Clinical data of 132 patients newly diagnosed with primary nasal NKTCL was collected in the Tianjin Medical University Cancer Institute and Hospital from Jan. 2008 to Dec. 2013. The relationship between AMC and PLR in pre-treatment peripheral blood and 5-year overall survival (OS) and progression-free survival (PFS) of patients was analyzed retrospectively. Independent prognostic factors of patients were determined by univariate analysis and Cox regression analysis. Results: Pre-treatment peripheral blood AMC and PLR play important roles in the prognosis stratification of patients with primary nasal NKTCL. The prognosis in patients of AMC<0.5×109/L were higher than those of AMC≥0.5×109/L, The prognosis in patients of PLR<150 were higher than those of PLR≥150 (P<0.05). Based on the four independent risk factors of staging, ECOG scoring, AMC and PLR, we tried to establish a new prognostic model, dividing all patients into three different risk groups and found that the 5-year OS and PFS of three groups had significant statistical differences. Conclusion: Peripheral blood AMC and PLR were significantly correlated with the prognosis of patients with primary nasal NKTCL. The new prognostic patterns based on the four independent risk factors, such as staging, ECOG scoring, AMC and PLR may be more convenient and more economical than IPI (International Prognostic Index, IPI) and KPI (Korean Prognostic Index, KPI).

Key words: Primary nasal natural killer/T-cell lymphoma, Absolute monocyte count, Platelet-lymphocyte ratio, Overall survival, Progression-free survival