本文選題：霍奇金淋巴瘤 + 預(yù)后　； 參考：《浙江大學(xué)》2017年碩士論文

【摘要】：目的:回顧性分析初發(fā)未治霍奇金淋巴瘤(Hodgkin lymphoma,HL)患者的臨床特征,評(píng)估其治療效果,并進(jìn)行預(yù)后相關(guān)因素分析。方法:本研究為單中心的回顧性研究,收集2010年1月至2016年10月期間就診于浙江大學(xué)醫(yī)學(xué)院附屬第一醫(yī)院的初發(fā)未治霍奇金淋巴瘤病例,共154例�；仡櫺苑治龌颊叩呐R床特征,評(píng)估其治療效果,采用Kaplan-Meier單因素生存分析及COX比例風(fēng)險(xiǎn)回歸模型進(jìn)行預(yù)后相關(guān)因素分析。結(jié)果:(1)154例HL患者年齡14-80歲,中位年齡36.5歲,男性患者92例(59.7%),女性62例(40.3%)。至隨訪截止時(shí)間,9例(5.8%)患者死亡,145例(94.2%)患者生存。所有患者接受ABVD或AVD方案化療,中位6個(gè)療程。治療總反應(yīng)率為91.6%(141例),復(fù)發(fā)率20.1%(31例)。154例HL患者中位無進(jìn)展生存時(shí)間(progression-free survival,PFS)22.5個(gè)月,其中47例復(fù)發(fā)或疾病進(jìn)展的HL患者中位PFS為12個(gè)月。(2)男性(P=0.016)、B 癥狀(P0.001)、Ⅲ-Ⅳ期(P=0.04)、IPI≥2 分(P=0.032)和C反應(yīng)蛋白25mg/L(P=0.004)的HL患者3年P(guān)FS率顯著降低。HL患者中伴有B癥狀組1年P(guān)FS率明顯低于無B癥狀組(P=0.001)。(3)單因素生存分析結(jié)果顯示:男性(P=0.004)、B癥狀(P0.001)、Ⅲ-Ⅳ期(P=0.006)、IPI 評(píng)分≥2 分(P=0.001)、IPS 評(píng)分2 分(P=0.006)、淋巴細(xì)胞計(jì)數(shù)0.6×109/L(P=0.004)、C 反應(yīng)蛋白25mg/L(P=0.001)、乳酸脫氫酶280μmol/L(P=0.013)的患者無進(jìn)展生存時(shí)間顯著縮短,有統(tǒng)計(jì)學(xué)意義。(4)多因素生存分析結(jié)果顯示:男性(HR2.309,95%CI1.131-4.714,P=0.022)、有B癥狀(HR 2.659,95%CI 1.280-5.524,P=0.009)的HL患者無進(jìn)展生存時(shí)間顯著縮短,表明男性和B癥狀是HL患者的不良預(yù)后因素。(5)Ⅰ-Ⅱ期患者54例(35.1%),Ⅲ-Ⅳ期患者100例(64.9%)。兩組患者的總生存率分別為98.1%、92%,無統(tǒng)計(jì)學(xué)意義(P=0.121)。Ⅰ-Ⅱ期患者3年P(guān)FS率顯著高于Ⅲ-Ⅳ期患者(83.3%vs68%,P=0.04)。在Ⅲ-Ⅳ期患者中,男性、B癥狀和淋巴細(xì)胞計(jì)數(shù)0.6×109/L的患者無進(jìn)展生存時(shí)間縮短,有統(tǒng)計(jì)學(xué)意義。結(jié)論:HL患者總體預(yù)后良好。男性、B癥狀是影響HL患者無進(jìn)展生存時(shí)間的獨(dú)立不良預(yù)后因素;對(duì)于Ⅲ-Ⅳ期HL患者,男性、B癥狀和淋巴細(xì)胞計(jì)數(shù)0.6×109/L是影響無進(jìn)展生存時(shí)間的不良預(yù)后因素。
[Abstract]:Objective: to retrospectively analyze the clinical features of patients with primary untreated Hodgkin lymphoma (Hodgkin lymphoma), evaluate the therapeutic effect and analyze the prognostic factors. Methods: a single center retrospective study was conducted to collect 154 cases of untreated Hodgkin's lymphoma from January 2010 to October 2016 in the first affiliated Hospital of Zhejiang University Medical College. The clinical features of the patients were analyzed retrospectively and the therapeutic effects were evaluated. The prognostic factors were analyzed by Kaplan-Meier single factor survival analysis and COX proportional risk regression model. Results the age of 154 cases of HL was 14-80 years old, the median age was 36.5 years old, 92 cases of male patients were 59.7%, 62 cases of female patients were 40.3%. At the end of follow-up, 9 patients died and 145 patients died (94. 2%). All patients received ABVD or AVD regimen chemotherapy, a median of 6 courses. The total response rate of the treatment was 91.6% and 141 cases, and the recurrence rate was 20.1%. The median progression-free survival time was 22.5 months in 31 cases with HL and 154 cases with HL. The median PFS of 47 patients with recurrent or progressive HL was 12 months. (2) male patients with P0. 016 / B symptom P 0.001, stage 鈪，

本文編號(hào)：1788190