[1]李晓利,张希远,史春雷,等.HBV感染的B细胞型非霍奇金淋巴瘤病人临床特征及预后分析[J].齐鲁医学杂志,2017,32(03):265-269.[doi:10.13362/j.qlyx.201703005]
 LI Xiaoli,ZHANG Xiyuan,SHI Chunlei,et al.CLINICAL FEATURES AND PROGNOSTIC ANALYSIS OF PATIENTS WITH B-CELL NON-HODGKIN’S LYMPHOMA AND HEPATITIS B VIRUS INFECTION[J].Medical Journal of Qilu,2017,32(03):265-269.[doi:10.13362/j.qlyx.201703005]
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HBV感染的B细胞型非霍奇金淋巴瘤病人临床特征及预后分析()
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《齐鲁医学杂志》[ISSN:1008-0341/CN:37-1280/R]

卷:
第32卷
期数:
2017年03期
页码:
265-269
栏目:
出版日期:
2017-08-07

文章信息/Info

Title:
CLINICAL FEATURES AND PROGNOSTIC ANALYSIS OF PATIENTS WITH B-CELL NON-HODGKIN’S LYMPHOMA AND HEPATITIS B VIRUS INFECTION
文章编号:
1008-0341(2017)03-0265-05
作者:
李晓利张希远史春雷王玲
青岛大学第二临床医院(青岛市中心医院)血液科,山东 青岛 266042
Author(s):
LI Xiaoli ZHANG Xiyuan SHI Chunlei WANG Ling
Department of Hematology, The Second Clinical Hospital of Qingdao University (Qingdao Central Hospital), Qingdao 266042, China
关键词:
B细胞型非霍奇金淋巴瘤乙型肝炎病毒预后
Keywords:
B-cell non-Hodgkin lymphoma hepatitis B virus prognosis
分类号:
R733.4
DOI:
10.13362/j.qlyx.201703005
文献标志码:
A
摘要:
目的 探讨乙型肝炎病毒(HBV)感染与B细胞型非霍奇金淋巴瘤(B-NHL)的关系,分析其临床特征及预后。
方法 收集345例初发B-NHL病人的临床资料,分为乙肝表面抗原(HBsAg)阳性组和HBsAg阴性组,比较B-NHL病人与全国一般人群HBV感染率的差异,并对两组病人的临床特征、预后进行分析。
结果 345例B-NHL病人HBsAg阳性率为18.8%,明显高于全国一般人群的7.2%,二项式检验显示差异有统计学意义(P<0.001)。与HBsAg阴性组中位发病年龄(58岁)相比,HBsAg阳性组(48岁)明显偏小(t=5.675,P<0.01)、更易累及肝、脾或腹膜后淋巴结(χ2=6.216~10.137,P<0.05)、疾病分期晚(Ⅲ/Ⅳ期)(χ2=9.771,P<0.05)、且预后较差(χ2=4.748~8.300,P<0.05)。单因素分析显示,HBsAg阳性组病人预后的不良因素包括:B症状、Ann Arbor分期(Ⅲ/Ⅳ期)、β2微球蛋白升高、未联合利妥昔单抗、未联合放疗(χ2=3.860~26.767,P<0.05)。多因素分析显示,B症状、Ann Arbor分期(Ⅲ/Ⅳ期)、未联合利妥昔单抗仍与预后差有关(95%CI=0.170~31.746,P<0.05)。
结论 B-NHL病人HBV感染率明显高于普通人群,HBV相关B-NHL具有其独特的临床表现,并且预后相对较差,利妥昔单抗的应用可改善HBsAg阳性病人预后。
Abstract:
Objective  To investigate the relationship between hepatitis B virus (HBV) infection and B-cell non-Hodgkin’s lymphoma (B-NHL), and to analyze the clinical features and prognosis of B-NHL patients with HBV infection.
Methods  A total of 345 B-NHL patients were divided into hepatitis B surface antigen (HBsAg)-positive group (n=65) and HBsAg-negative group (n=280). The clinical features and prognosis of the patients in the two groups were analyzed and the HBsAg-positive rate was compared between the 345 B-NHL patients and the general population in China.
Results  The HBsAg-positive rate in the 345 B-NHL patients was significantly higher than that in the general population in China (18.8% vs 7.2%, P<0.001, binomial test). Compared with the HBsAg-negative group, the HBsAg-positive group had a significantly younger median age of onset (t=5.675,P<0.01), significantly higher incidence of involvement of the liver, spleen, or retroperitoneal lymph node (χ2=6.216-10.137,P<0.05), a significantly later stage of disease (Ⅲ/Ⅳ) (χ2=9.771,P<0.05), and a significantly worse prognosis (χ2=4.748-8.300,P<0.05). Univariate analysis showed that the poor prognostic factors for the patients in the HBsAg-positive group were B symptoms, Ann Arbor staging (Ⅲ/Ⅳ), increased β2-microglobulin level, not combined with rituximab, and not combined with radiotherapyd (χ2=3.860-26.767,P<0.05). Multivariate analysis showed that the poor prognosis was associated with B symptoms, Ann Arbor staging (Ⅲ/Ⅳ), and not combined with rituximab (95%CI=0.170-31.746,P<0.05).
Conclusion  The HBV infection rate in B-NHL patients is significantly higher than that in the general population in China. B-NHL patients with HBV infection have unique clinical manifestations and relatively poor prognosis and rituximab can improve the prognosis of B-NHL patients with HBV infection.
更新日期/Last Update: 2017-08-12