Objective: To compare the prognostic value of different models in patients with early-stage diffuse large B-cell lymphoma (DLBCL).
Methods: Early-stage DLBCL patients diagnosed from January 2000 to December 2012 were analyzed retrospectively. All patients received with at least 2 cycles of immunochemotherapy R-CHOP regimen (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) with or without radiotherapy. The prognostic value of international prognostic index (IPI) , revised IPI (R-IPI) and enhanced IPI (NCCN-IPI) was compared.
Results: Ninety-seven cases of early-stage DLBCL were included in the study. The median age was 58 years (15-88 years) with a median follow-up of 34.7 months (range 7.3-77.4 months). The expected 5-year overall survival (OS) for entire group was 82%. There was no patient in the high risk group according to IPI or NCCN-IPI. According to IPI, the 5-year OS in the low, low intermediate, high intermediate risk groups were 95%, 38% and 60%, respectively. According to R-IPI, the 5-year OS in the very good, good, and poor risk groups were 93%, 75% and 60%, respectively. According to NCCN-IPI, the 5-year OS in the low, low intermediate, high intermediate risk groups were 92%, 85% and 29%, respectively.
Conclusion: NCCN-IPI would be of an ideal prognostic model for early-stage DLBCL patients.
目的: 探讨不同分层方法对早期弥漫大B细胞淋巴瘤（DLBCL）患者预后的价值。
方法: 回顾性分析2007年1月至2012年12月所诊断的97例初治Ⅰ/Ⅱ期DLBCL患者资料，所有患者至少接受2个周期R-CHOP（利妥昔单抗、环磷酰胺、多柔比星、长春新碱、泼尼松）方案免疫化疗。比较国际预后指数（IPI）、修订国际预后指数（R-IPI）、强化国际预后指数（NCCN-IPI）的预后价值。
结果: 97例患者中男50例，女47例，中位年龄58（15~88）岁。中位随访34.7（7.3~77.4）个月，全组患者的预计5年总生存（OS）率为82%。IPI分层中，低危、低中危和高中危组患者的5年OS率分别为95%、38%和60%（P<0.001）；R-IPI分层中，预后非常好、良好和差组患者的5年OS率分别为93%、75%和60%（P=0.226）；NCCN-IPI分层中，低危、低中危和高中危组患者5年OS率分别为92%、85%和29%（P<0.001）。
结论: NCCN-IPI是早期DLBCL患者的理想预后指标。