摘要
目的目前关于原发中枢神经系统淋巴瘤(PCNSL)临床特点和预后的研究较少。文中旨在对93例PCNSL患者进行分析,探讨PCNSL的临床特点及预后影响因素。方法回顾性分析2013年9月至2019年10月郑州大学第一附属医院肿瘤科收治的93例PCNSL患者临床资料。其中单纯手术10例,术后化疗37例,术后放化疗12例,术后化疗联合利妥昔单抗34例。统计分析单纯化疗者、放化疗联合者、化疗联合利妥昔单抗者的中位生存期。随访开始时间2013年9月,截至时间为2019年10月1日。通过Kaplan-Meier法和Cox多因素回归模型进行病例资料分析不良预后因素,并统计比较不良预后因素的中位生存期。结果93例PCNSL患者发病中位年龄为54(14~88)岁。临床表现复杂,以颅脑内压增高症状为主。中位随访时间为25个月。93例PCNSL患者中位生存期13(95%CI:12~17)个月,2年生存率38.7%。术后单纯化疗者中位生存期明显小于放化疗联合者(15个月vs 31个月,P=0.00)。化疗联合利妥昔单抗者中位生存期明显大于单纯化疗者(22个月vs 15个月,P=0.002)。脑脊液乳酸脱氢酶升高(RR=1.550,95%CI:0.707~3.397)和未使用利妥昔单抗(RR=6.308,95%CI:1.904~20.898)是PCNSL的不良预后因素(P<0.05)。脑脊液乳酸脱氢酶正常者中位生存期明显大于脑脊液乳酸脱氢酶升高者(28个月vs 17个月,P<0.05)。使用利妥昔单抗者中位生存期明显大于未使用利妥昔单抗(22个月vs 14个月,P<0.05)。结论选择术后放化疗或术后化疗联合利妥昔单抗的PCNSL患者治疗效果较好,未使用利妥昔单抗和脑脊液乳酸脱氢酶升高的患者预后不佳。
Objective There are few studies on the clinical features and prognosis of primary central nervous system lymphoma(PCNSL).In this paper,93 patients with PCNSL were analyzed to explore the clinical characteristics and prognostic factors of PCNSL.Methods The clinical data of 93 PCNSL patients admitted to the Department of Oncology at the First Affiliated Hospital of Zhengzhou University from September 2013 to October 2019 were retrospectively analyzed.Among them,there were 10 cases of pure operation,37 cases of postoperative chemotherapy,12 cases of postoperative chemoradiotherapy,34 cases of postoperative chemotherapy combined with rituximab.The median survival time of patients with chemotherapy alone,chemotherapy combined with chemoradiotherapy,and chemotherapy combined with rituximab was statistically analyzed.The follow-up began in September 2013 and ended on October 1,2019.The adverse prognostic factors were analyzed by Kaplan-Meier and Cox multivariate regression model,and the median survival of adverse prognostic factors was statistically compared.Results The median age of 93 PCNSL patients was 54(14-88)years.The clinical manifestations are complex and the main symptoms are increased intracranial pressure.The median follow-up time was 25 months.The median survival time of 93 PCNSL patients was 13 months(95%CI:12-17),and the 2-year survival rate was 38.7%.The median survival time of postoperative patients with chemotherapy alone was significantly lower than that of patients receiving chemotherapy combined with chemoradiotherapy(15 months vs 31 months,P=0.00).The median survival time of patients receiving chemotherapy combined with rituximab was significantly higher than that of patients receiving chemotherapy alone(22 months vs 15 months,P=0.002).Increased lactate dehydrogenase in cerebrospinal fluid(RR=1.550,95%CI:0.707-3.397)and non-use of rituximab(RR=6.308,95%CI:1.904-20.898)were adverse prognostic factors for PCNSL(P<0.05).The median survival time of normal CSF LACTate dehydrogenase was significantly high
作者
王进隆
张旭东
陈清江
陈国荣
吴少璇
杨万秋
尹美凤
薛伍君
吴晓爽
唐灿伟
WANG Jin-long;ZHANG Xu-dong;CHEN Qing-jiang;CHEN Guo-rong;WU Shao-xuan;YANG Wan-qiu;YIN Mei-feng;XUE Wu-jun;WU Xiao-shuang;TANG Can-wei(Department of Oncology,the Third Affiliated Hospital of Xinxiang Medical University,Xinxiang 453000,Henan,China;Department of Oncology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450001,Henan,China)
出处
《医学研究生学报》
CAS
北大核心
2020年第11期1171-1175,共5页
Journal of Medical Postgraduates
基金
国家自然科学基金(81700187)。
关键词
结外淋巴瘤
原发中枢神经系统
临床特点
预后分析
lymphoma
primary central nervous lystem
clinical haracteristics
prognostic analysis
