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目的:探讨淋巴细胞单核细胞比值(LMR)在弥漫大B细胞淋巴瘤(DLBCL)随访中的作用。方法:2005-2015年在我院对130例原发性DLBCL患者进行一线化疗,并随访观察。结果:130例患者中有40例(30.8%)在随访时复发,中位复发时间为12.5(1~101)个月。复发时LMR的最佳界值为2.8,其曲线下面积为0.804(P=0.001)。LMR<2.8的患者复发率较LMR≥2.8的患者明显升高,其1年内的复发率分别为26.8%和10.1%(P=0.019);2年内的复发率分别为41.5%和14.6%(P=0.001);5年内的复发率分别为51.2%和18.0%(P=0.000)。多因素分析发现随访时LMR和LDH与复发相关,相关系数分别为2.546和2.708。低LMR值与较短总生存期及无进展期生存有关,LMR<2.8提示不良的预后(总生存期:P=0.000;无进展生存期:P=0.000)。结论:LMR可以作为DLBCL一线化疗后的随访指标,LMR降低提示复发可能。
Objective: To investigate the role of lymphocyte monocyte ratio (LMR) in the follow-up of diffuse large B cell lymphoma (DLBCL). Methods: From January 2005 to 2015, 130 patients with primary DLBCL were treated with first-line chemotherapy in our hospital and followed up. RESULTS: Forty of the 130 patients (30.8%) relapsed at follow-up, with a median recurrence of 12.5 (1 to 101) months. The best cutoff value for LMR at recurrence was 2.8, with an area under the curve of 0.804 (P = 0.001). The relapse rate in patients with LMR <2.8 was significantly higher than that in patients with LMR≥2.8. The recurrence rates in one year were 26.8% and 10.1%, respectively (P = 0.019). The recurrence rates in two years were 41.5% and 14.6%, respectively = 0.001). The recurrence rates in 5 years were 51.2% and 18.0%, respectively (P = 0.000). Multivariate analysis found that LMR and LDH were associated with recurrence at follow-up, with correlation coefficients of 2.546 and 2.708, respectively. Low LMR values were associated with shorter overall survival and progression-free survival, with LMR <2.8 suggesting poor prognosis (overall survival: P = 0.000; progression-free survival: P = 0.000). Conclusion: LMR can be used as a follow-up index after first-line DLBCL chemotherapy, and the decrease of LMR may indicate the possibility of recurrence.