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目的:探讨结外弥漫大B细胞淋巴瘤(DLBCL)患者初发时外周血绝对淋巴细胞计数(ALC)与其临床特征的关系及对预后的影响。方法:回顾性分析初发的结外DLBCL患者的临床特征及疗效,分析不同ALC水平与结外DLBCL患者各临床特征关系及其预后的相关性。结果:本组59例结外DLBCL患者,以ALC=1.0×109/L为分界点,ALC减少组18例(ALC<1.0×109/L),ALC非减少组41例(ALC>1.0×109/L),2组性别、年龄、LDH水平、ECOG评分、IPI预后指数等临床特征差异无统计学意义(均P>0.05),但ALC减少组常伴有临床分期的升高及non-GCB型增多(均P<0.05),且临床缓解率相对较低(P<0.05);P53缺失、Bcl-6及c-myc基因的异常表达与ALC高低均无相关性(P>0.05)。结论:ALC减少可以作为结外DLBCL患者的辅助性预后判断指标。
Objective: To investigate the relationship between peripheral blood absolute lymphocyte count (ALC) and its clinical characteristics and prognosis in patients with extracranial diffuse large B-cell lymphoma (DLBCL). Methods: The clinical features and efficacy of newly diagnosed DLBCL patients were retrospectively analyzed. The relationship between different ALC levels and the clinical features of DLBCL patients and their prognosis were analyzed. Results: ALC = 1.0 × 109 / L was the cut-off point in 59 patients with DLBCL. ALC decreased in 18 patients (ALC <1.0 × 109 / L) and ALC decreased in patients (ALC> 1.0 × 109 / L). There was no significant difference in gender, age, LDH level, ECOG score and IPI prognosis index between the two groups (all P> 0.05). However, the ALC reduction group was often accompanied by an increase in clinical stage and non-GCB (All P <0.05), and the clinical remission rate was relatively lower (P <0.05). There was no correlation between the abnormal expression of Bcl-6 and c-myc gene and the loss of P53 (P> 0.05). Conclusion: ALC reduction can be used as an adjunctive prognostic indicator in patients with extra-corporeal DLBCL.