| Objective:Hodgkin lymphoma(HL)responds better to modern treatments.Currently,there are many studies on the long-term efficacy and prognosis of HL patients,and few studies on factors influencing the short-term efficacy of HL patients.This study focuses on the effect of serum albumin(ALB)and prealbumin(PA)on the short-term efficacy of HL and its clinical significance.Methods:On the basis of the World Health Organization(WHO)HL classification criteria,the clinical data of HL patients diagnosed firstly in our unit from January 2010to July 2016 were selected to collect basic information,clinical manifestations,laboratory tests,treatment plans and the short-term efficacy.These information was retrospectively summarized and analyzed and the complete remission(CR)rate was counted.The statistical software was used to analyze the factors affecting the HL short-term efficacy—CR rate.According to groups based on ALB and PA levels,the clinical characteristics of the two groups and their effects on the short-term efficacy of HL were analyzed.Results:From January 2010 to July 2016,103 eligible patients with HL were selected.Of the 103 patients with HL,60 were CR(58.3%),37 were PR(35.9%),and the total effective rate was 94.2%;45 female patients,58 male patients,the ratio was1:1.3;the age of onset was mainly young and middle-aged;there were 33 cases(32.0%)with B symptoms at the first diagnosis,42 cases(40.8%)with extranodal invasion,73cases(70.9%)with more than 3 lymph node areas invaded;before treatment,there were35 patients(34.0%)with peripheral white blood cell(WBC)count>10×10~9/L,35patients(34.0%)with ALB<35 g/L,60 patients(58.3%)with PA<200mg/L.In all cases,there were 87 cases(84.5%)with 0~2 points of IPS,16 cases(15.5%)with more than 3 points.According to HL clinical stage,51 cases(49.5%)were staging into I/II and52 cases(50.5%)were III/IV.According to pathological type of HL,there were 4 cases(3.9%)with nodular lymphocyte predominant Hodgkin lymphoma,40 cases(38.8%)with nodular sclerosisclassical Hodgkin lymphoma,4cases(3.9%)with lymphocyte-rich classical Hodgkin lymphoma,39 cases(37.9%)with mixed cellularity classical Hodgkin lymphoma,and 16 cases(15.5%)with unclassified HL,none with lymphocyte-depleted classical Hodgkin lymphoma.Univariate analysis showed that low ALB,low PA,elevated WBC,advanced stage,B-symptoms,extranodal invasion,and more than 3 lymph nodal sites invaded were negative prognostic factors affecting the CR rate of HL.CR was took as the dependent variable and the above factors were included in the Logistic regression model.The results showed that only ALB(P=0.005,OR=0.135)was an independent factor affecting CR,suggesting that low ALB was less likely to achieve CR.In addition,the analysis of PA and ALB alone as independent variables in Logistic regression model revealed that the difference was statistically significant(P<0.05),suggesting that low PA was less likely to achieve CR.The characteristics of both groups were analyzed by ALB and PA levels,and among the patients with ALB<35 g/L,7 cases(20%)achieved CR;among the patients with ALB≥35 g/L,53 cases(77.9%)achieved CR.Among the patients with PA<200mg/L,23cases(38.3%)achieved CR;among the patients with PA≥200mg/L,37 cases(86.0%)achieved CR.In the research,35 cases had ALB<35g/L and 68 cases had ALB≥35g/L;the clinical features of both groups showed that patients with ALB<35 g/L often had B symptoms,advanced stage,extranodal involvement,high IPS score and low CR rate;similarly,by analysing the data of 60 cases of PA<200mg/L and 43 cases of PA≥200mg/L,the results showed that patients with PA<200mg/L often accompanied by B symptoms,extranodal involvement,high IPS score,more than 3 lymph nodal sites invaded and low CR rate.Conclusion:HL is a kind of malignant tumor that originates from the lymphatic system.Most studies currently consider that its cells are derived from B lymphocytes.The epidemiological data in China are different from those in Europe and the United States.At present,after comprehensive treatment such as radiotherapy and chemotherapy,the disease remission rate is high and patients can live for a long time.Previous studies have shown that ALB and PA are important in the treatment and prognosis of the patients with cancer.This study found that low ALB and low PA are associated with low CR rate in patients with HL,and ALB is an independent factor affecting CR rate,suggesting that ALB and PA can provide important information for the short-term efficacy of HL patients.In the treatment of HL,it may be possible to improve short-term efficacy and long-term prognosis by strengthening the supplementation of ALB and improving nutrition. |
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