摘要
目的 探讨滤泡辅助性T细胞(Tfh)/滤泡调节性T细胞(Tfr)、血清可溶性程序性死亡配体(sPD-L1)、纤溶酶α2纤溶酶抑制剂复合物(PIC)与弥漫大B细胞淋巴瘤(DLBCL)患者化疗效果的关系。方法 将2019年4月至2022年4月在周口市中心医院接受化疗治疗的106例DLBCL患者纳入本次研究,根据化疗效果分为有效组(68例)和无效组(38例)。对比两组患者初诊时的外周血Tfh/Tfr、sPD-L1、PIC及各项基础资料、病情数据,采用logistic回归模型分析影响弥漫大B细胞淋巴瘤患者化疗疗效的相关因素。结果 106例患者平均化疗2个周期,其中68例患者达到化疗有效,38例患者化疗无效,化疗有效组患者的Tfh、Tfh/Tfr、sPD-L1、PIC低于无效组(P<0.05)。无效组患者乳酸脱氢酶(LDH)>350 U·L^(-1)占比、肿瘤分期Ⅲ、Ⅳ期占比、发生结节外侵犯占比、淋巴瘤国际预后指数(IPI)评分>2分占比高于有效组(P<0.05)。两组患者的美国东部肿瘤协作组(ECOG)评分、EB病毒(EBV)感染率、骨髓浸润占比、结节外侵犯数量、肿瘤细胞起源情况比较,差异无统计学意义(P>0.05)。logistic回归模型结果显示:LDH水平>350 U·L^(-1)、肿瘤分期为Ⅲ期或Ⅳ期、IPI评分>2分、Tfh/Tfr高、sPD-L1高、PIC高是DLBCL患者化疗无效的独立危险因素(P<0.05)。结论 LDH水平>350 U·L^(-1)、肿瘤分期为Ⅲ期或Ⅳ期、IPI评分>2分、Tfh/Tfr较高、sPD-L1较高、PIC较高是DLBCL患者化疗无效的独立危险因素。
Objective To explore the relationship between follicular helper T cells(Tfh)/follicular regulatory T cells(Tfr),serum soluble programmed deathligand-1(sPD-L1),plasmin inhibitor complex(PIC)and chemotherapy effect in patients with diffuse large B-Cell lymphoma(DLBCL).Methods A total of 106 patients with DLBCL who received chemotherapy in Zhoukou Central Hospital from April 2019 to April 2022 were included in this study,and were divided into effective group(68 cases)and ineffective group(38 cases)according to the chemotherapy effect.The peripheral blood Tfh/Tfr,sPD-L1,PIC,basic data and disease data of the two groups were compared at the time of initial diagnosis.Logistic regression model was used to analyze the related factors affecting the chemotherapy efficacy of patients with diffuse large B-cell lymphoma.Results A total of 106 patients received chemotherapy for an average of 2 cycles,of which 68 patients achieved effective chemotherapy and 38 patients failed chemotherapy.The Tfh,Tfh/Tfr,sPD-L1 and PIC of patients with effective chemotherapy were lower than those of patients with ineffective chemotherapy(P<0.05).The proportion of patients with lactate dehydrogenase(LDH)>350 U·L^(-1),the proportion of tumor stagesⅢandⅣ,the proportion of extranodal invasion and the proportion of lymphoma international prognosis index(IPI)score>2 in the ineffective group were higher than those in the effective group(P<0.05).There was no significant difference between the two groups in the score of the Eastern American Cancer Cooperative Group(ECOG),the infection rate of EBV,the proportion of bone marrow infiltration,the number of extranodal invasion and the origin of tumor cells(P>0.05).Logistic regression model showed that LDH level>350 U·L^(-1),tumor stageⅢorⅣ,IPI score>2,Tfh/Tfr high,sPD-L1 and PIC levels high were independent risk factors for chemotherapy failure in patients with DLBCL(P<0.05).Conclusion LDH level>350 U·L^(-1),tumor stageⅢorⅣ,IPI score>2,higher Tfh/Tfr,higher sPD-L1 and higher PIC are independen
作者
梁倩
LIANG Qian(Department of Hematology,Zhoukou Central Hospital,Zhoukou 466000,China)
出处
《河南医学研究》
CAS
2023年第18期3299-3302,共4页
Henan Medical Research
