原发性胃肠道淋巴瘤患者的临床特征研究及预后情况分析

Clinical characteristics and prognosis of patients with primary gastrointestinal lymphoma

摘要:

目的 分析原发性胃肠道淋巴瘤（PGIL）的临床病理特征及预后情况。方法 回顾性分析2013年1月—2023年1月首都医科大学附属北京友谊医院收治的122例PGIL患者的临床资料，所有患者接受化疗或手术治疗，治疗后对患者进行为期2年的随访，根据预后情况将其分为预后良好组（85例）和预后不良组（37例）。比较两组患者的临床资料，通过多因素一般Logistic回归分析筛选患者预后不良的风险因素。结果 预后不良组患者年龄、乳酸脱氢酶（LDH）值升高率高于预后良好组，T细胞表型占比、单纯接受手术治疗占比及临床分期在Ⅲ、Ⅳ期的占比高于预后良好组（P <0.05）。多因素一般Logistic回归分析结果显示：年龄大［O^R=1.217（95% CI：1.116，1.327）］、LDH值升高［O^R=3.958（95% CI：1.296，12.088）］、细胞表型为T细胞［O^R=9.948（95% CI：1.491，66.389）］及临床分期为Ⅲ、Ⅳ期［O^R=3.600（95% CI：1.111，11.660）］均为PGIL患者预后不良的危险因素（P <0.05），治疗方法为单纯化疗［O^R=0.039（95% CI：0.002，0.631）］、治疗方法为手术联合化疗［O^R=0.027（95% CI：0.002，0.437）］均为预后不良的保护因素（P <0.05）。结论 年龄、LDH水平、病理分型、治疗方式及临床分期是影响原发性胃肠道淋巴瘤患者预后的关键因素，临床可据此制订个体化干预方案以改善患者预后。

Abstract:

Objective To analyze the clinicopathological characteristics and prognosis of primary gastrointestinal lymphoma (PGIL).Methods The clinical data of 122 patients with PGIL treated at Beijing Friendship Hospital, Capital Medical University, between January 2013 and January 2023 were retrospectively analyzed. All patients received chemotherapy or surgery and were followed for 2 years after treatment. According to prognosis, they were divided into a favorable-prognosis group (n = 85) and an unfavorable-prognosis group (n = 37). Clinical data were compared between the groups, and multivariable logistic regression was used to identify risk factors for an unfavorable prognosis.Results Patients in the unfavorable-prognosis group were older and had higher proportions of elevated lactate dehydrogenase (LDH), a T-cell phenotype, surgery alone, and stage III-IV disease than those in the favorable-prognosis group (P < 0.05). Multivariable logistic regression showed that older age [O^R = 1.217 (95% CI: 1.116, 1.327) ], elevated LDH [O^R = 3.958 (95% CI: 1.296, 12.088) ], a T-cell phenotype [O^R = 9.948 (95% CI: 1.491, 66.389) ], and stage III-IV disease [O^R = 3.600 (95% CI: 1.111, 11.660) ] were risk factors for an unfavorable prognosis in patients with PGIL (P < 0.05), whereas chemotherapy alone [O^R = 0.039 (95% CI: 0.002, 0.631) ] and surgery combined with chemotherapy [O^R = 0.027 (95% CI: 0.002, 0.437) ] were protective factors (P < 0.05).Conclusion Age, LDH level, pathological type, treatment modality, and clinical stage are key factors affecting the prognosis of patients with PGIL. These factors may inform individualized interventions to improve prognosis.