Preliminary Analysis Of Early Efficacy And Related Factors Of Diffuse Large B-cell Lymphoma

Objective: To explore the early curative effect and related influencing factors through analyzing the clinical data of patients with diffuse large B cell lymphoma(DLBCL).Methods: We retrospectively analyzed the data of 156 cases of DLBCL patients diagnosed by pathology and immunohistochemistry from Affiliated Hospital of Zunyi Medical College from January 2007 to January 2017.The therapeutic effects with CHOP regimen or R-CHOP regimen in diffuse large B-cell lymphoma(DLBCL)were observed after 2 courses.Univariate analysis was used to analyze the patients’ ages,genders,clinical stage,extranodal organ involvement,marrow immature lymphocyte percentage,expression level of Ki-67 and Bcl-2 and therapeutic options with t test or c 2 test.Bivariate non-conditional logistic regression was used to analyze the factors influencing the effect of early treatment,and stratified analysis was used to analyze the efficacy of different independent risk factor groups.Results:(1)There were 99 males and 57 females in 156 cases of patients with DLBCL,the sex ratio(male: female)of 1.74: 1.of which used CHOP regimen 95 cases,R-CHOP regimen 61 cases,And 106 cases were effective,ineffective in 50 cases,the effective rate was 67.9%.(2)Univariate analysis of the relationship between each factors and the early curative effect:(1)The effective rate of patients￡60 years of age was 72.4%,patients>60 years of age was 55.0%,and there was a statistically significant difference between the two groups of ages(P<0.05);(2)The effective rate of treatment in clinical stage I and stage II was76.7%,57.1% in clinical stage III and IV,and there was a statistically significant difference between the two groups(P<0.05);(3)The effective rate of treatment in patients with extranodal organ involvement number ￡ 1 was 76.3%,extranodal organ involvement number >1 was 42.1%,and there was a statistically significant difference between the two groups(P<0.05);(4)The effective rate of treatment in patients with low expression of Ki-67 was 76.9%,47.9% in patients with high expression,and there was a statistically significant difference between the two groups(P<0.05);(5)The effective rate of treatment in patients treated with R-CHOP regimen was 83.6%(51/61),57.9%(55/95)in patients treated with CHOP regimen,and there was a statistically significant difference between the two groups(P<0.05);(6)There was no significant difference between different sex groups,marrow immature lymphocyte percentage and Bcl-2 group(P> 0.05).(3)Bivariate non-conditional logistic regression was used to analyze the age,clinical stage,extranodal organ involvement,expression level of Ki-67 and therapeutic options,and the analysis showed that the clinical stage and expression of Ki-67 were an independent risk factors for early treatment(P<0.05,OR>1).(4)To analyze the clinical efficacy of CHOP group and R-CHOP group in different clinical stages and Ki-67 expression levels showed that the early effective rate of R-CHOP regimen in stage III and IV stage was significantly higher than that of CHOP(84.6% vs 40.9%),there was a statistically significant differences between the two groups(P<0.05);There was no significant difference in the early effective rate between the two groups in stage I and stage II(P> 0.05).There was no significant difference in the expression of Ki-67 between the two groups(P> 0.05).Conclusion:(1)Clinical staging and the expression level of Ki-67 are independent risk factors that affect the therapeutic efficacy of DLBCL patients.(2)For DLBCL patients,early detection,early diagnosis,early treatment and early use of rituximab regimen(R-CHOP)in stage III + IV patients can improve efficacy,the CHOP regimen can still be used as an initial treatment for conditional phase I patients with stage I and II.(3)Currently,the detection method and the threshold judgment of expression level of Ki-67 need to be further studied.