摘要
目的基于美国国立癌症研究所的监测、流行病学和结果(SEER)数据库中原发性肺弥漫大B细胞淋巴瘤(PP DLBCL)患者的资料,探讨不同治疗方案对其的疗效差异及预后影响因素。方法选择SEER数据库中1983-2018年经病理学确诊的529例PP DLBCL患者为研究对象。采用SEERstat软件(V8.3.9)软件,提取患者的年龄、性别、种族、原发部位、Ann Arbor分期、B症状、治疗方法、生存时间、生存结局、死亡原因等临床信息。采用倾向性评分匹配(PSM)模型的最近邻匹配法,以1∶1例数比对化疗和未化疗组(PSM模型1)、放疗和未放疗组(PSM模型2)患者进行匹配。2组患者的构成比比较,采用χ^(2)检验。采用Kaplan-Meier法计算总体生存(OS)率,采用log-rank检验比较不同类型患者的OS率。采用了Fine-Gray竞争风险分析法评估癌症特异性生存期(CSS)。采用Cox比例风险回归模型对影响患者OS率的因素进行单因素及多因素分析。本研究遵循的程序符合2013年修订版《世界医学协会赫尔辛基宣言》要求。结果①PSM模型1成功匹配化疗和未化疗组共计142对患者,PSM模型2成功匹配放疗组和未放疗组共计86对患者。匹配后,化疗组和未化疗组、放疗组和未放疗组患者的年龄、性别、种族、Ann Arbor分期、B症状构成比等分别比较,差异均无统计学意义(均P>0.05)。②Ann ArborⅠ/Ⅱ期PP DLBCL患者中,单纯化疗和放、化疗联合治疗患者的OS率(PSM前:HR=0.469,95%CI:0.345~0.638,P<0.001;HR=0.295,95%CI:0.181~0.480,P<0.001。PSM模型1:HR=0.582,95%CI:0.400~0.847,P=0.005;HR=0.377,95%CI:0.186~0.762,P=0.007。PSM模型2:HR=0.232,95%CI:0.121~0.445,P<0.001)和CSS率(PSM前:HR=0.612,95%CI:0.418~0.895,P=0.011;HR=0.309,95%CI:0.169~0.567,P<0.001。PSM模型1:HR=0.571,95%CI:0.370~0.882,P=0.012;HR=0.343,95%CI:0.159~0.741,P=0.007。PSM模型2:HR=0.346,95%CI:0.160~0.750,P=0.007)均较未放、化疗者增高,并且差异均有统计学意义。PSM前、后,单纯放疗�
ObjectiveTo evaluate the differences in efficacy among different treatment regimens and prognostic factors of patients with primary pulmonary diffuse large B-cell lymphoma(PP DLBCL)based on data from the Surveillance,Epidemiology,and End Results(SEER)database.MethodsA total of 529 patients with PP DLBCL who were diagnosed from 1983 to 2018 and included in the SEER database were selected as study subjects.The patient′s age,gender,race,primary site,Ann Arbor stage,B symptoms,treatment methods,survival time,survival outcome,cause of death and other clinical information were extracted using SEERstat software(V8.3.9).The nearest neighbor matching method was used to match patients with chemotherapy and non-chemotherapy(PSM model 1),radiotherapy and non-radiotherapy(PSM model 2)at a ratio of 1∶1.Theχ^(2)test was used to compared the composition ratio of patients between two groups.The Kaplan-Meier method was used to calculate the overall survival(OS)rate of patients,and the log-rank test was used to compare the survival rates among different types of patients.Fine-Gray competing risks analysis was used to estimate cancer-specific survival(CSS).Univariate and multivariate analysis of factors influencing OS rate of patients were performed by Cox proportional hazards regression model.This study was in line with World Medical Association Declaration of Helsinki revised in 2013.Results①A total of 142 pairs of patients were successfully matched between chemotherapy and non-chemotherapy groups in PSM model 1,and 86 pairs of patients were successfully matched between radiotherapy and non-radiotherapy group in PSM model 2.After PSM,the age,gender,race,Ann Arbor stage,and B-symptom composition ratio of patients in the chemotherapy and no-chemotherapy groups,and in the radiotherapy and no-radiotherapy groups were compared respectively,and the differences were not statistically significant(all P>0.05).②Among Ann Arbor stageⅠ/ⅡPP DLBCL patients,the OS rate(before PSM:HR=0.469,95%CI:0.345-0.638,P<0.001;HR=0.295,95%CI:0.1
作者
顾思梦
王欣
牛挺
Gu Simeng;Wang Xin;Niu Ting(Department of Hematology,West China Hospital,Sichuan University,Chengdu 610041,Sichuan Province,China)
出处
《国际输血及血液学杂志》
CAS
2023年第6期511-519,共9页
International Journal of Blood Transfusion and Hematology
基金
四川大学华西医院成果转化项目(CGZH21001)
四川大学华西医院学科卓越发展1.3.5工程项目(ZYJC21007)
成都市科技局技术创新研发项目(2022-YF05-01444-SN)。
