Prognostic influencing factors of diffuse large B-cell lymphoma analyzed by time-dependent covariate Cox regression model / 肿瘤研究与临床

ABSTRACT

Objective:To investigate the influencing factors of the prognosis of patients with diffuse large B-cell lymphoma (DLBCL).Methods:The clinical data of 431 DLBCL patients admitted to Shanxi Province Cancer Hospital from January 2013 to December 2020 were retrospectively analyzed. Univariate and multivariate time-dependent covariate Cox regression model were constructed. The relationship between the clinical characteristics and prognosis of patients was analyzed.Results:The age, tumor diameter, tumor width all met the proportion hazard hypothesis (correlation coefficients were 0.044, -0.015, and -0.680, respectively, all P > 0.05). The effects of disease grade, erythrocyte sedimentation rate (ESR) increased or not, and CD20 positive or not on survival time changed with time change. When the above indicators did not meet the proportional hazard hypothesis, they were time-dependent covariables (all P < 0.05). Time-dependent covariate Cox regression multivariate analysis showed that lactate dehydrogenase (LDH) increased or not ( χ2 = 13.78, P < 0.001), β 2 microglobulin (β 2-MG) increased or not ( χ2 = 5.36, P = 0.021), tumor diameter ( χ2 = 4.12, P = 0.042) and CD20 positive or not ( χ2 = 7.09, P = 0.008) and ESR increased or not ( χ2 = 5.46, P = 0.019) were independent influencing factors of the death of DLBCL patients. Conclusions:Patients with elevated LDH, increased β 2-MG, tumor diameter, increased ESR and CD20 positive have poor prognosis. Clinicians should take further treatment measures for these patients to reduce the mortality.