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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。
BACKGROUND & OBJECTIVE: Natural killer / T-cell lymphoma (NKTCL) is a rare type of malignant lymphoma, which has great difference in clinical manifestation and overall curative effect. There is no definite The risk stratification guides the prognosis. The aim of this study was to explore the significance of absolute monocyte count (AMC), platelet-lymphocyte ratio (PLR) in primary nasal NKTCL before treatment, More precise risk stratification, so as to select the appropriate treatment to improve prognosis. Methods: Clinical data of 132 patients with primary nasal NKTCL who were newly diagnosed at Tumor Hospital of Tianjin Medical University from January 2008 to December 2013 were collected. The relationship between pre-treatment peripheral blood AMC, PLR and 5-year overall survival (OS) and progression-free survival (PFS) was analyzed retrospectively. Factors affecting the prognosis of patients using univariate analysis and Cox proportional hazards model multivariate analysis. Results: Before treatment, peripheral blood AMC and PLR played an important role in the prognosis of patients with primary nasal NKTCL. The prognosis of patients with AMC less than 0.5 × 109 / L was significantly better than those with AMC of 0.5 × 109 / L or more, and those with PLR less than 150 were superior to those with PLR of 150 or more (P <0.05). Based on the four independent risk factors of staging, ECOG score, AMC and PLR, we tried to establish a new prognostic model that divided all patients into three different risk groups and found that the 5-year OS and PFS differences among the 3 groups There was statistical significance (P <0.05). Conclusion: The peripheral blood AMC, PLR and the prognosis of patients with primary nasal NKTCL significantly correlated. The new prognostic model, which consists of four independent risk factors including staging, ECOG score, AMC and PLR, may be more accurate and convenient than International Prognostic Index (IPI) and Korean Prognostic Index (KPI) Economical and practical.