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从症状到诊断的时间延长与扩散大B细胞淋巴瘤的无进展生存率较低有关
Susanna Tokola1, Katja Marin2,3, Milla E L Kuusisto4,5
1Department of Radiotherapy and Oncology, Oulu University Hospital, Oulu, Finland.
Cancer medicine
|November 23, 2025
概括
诊断时间影响扩散大B细胞淋巴瘤 (DLBCL) 的结果. 较长的诊断延迟,特别是在活检之前,会使无进展生存率 (PFS) 恶化,特别是在高Ki67 DLBCL. 相反,从活检到治疗的时间间隔较长可能有利于某些患者.
科学领域:
- 在瘤学瘤学.
- 血液学 血液学 血液学
- 临床研究 临床研究
背景情况:
- 扩散性大B细胞淋巴瘤 (DLBCL) 是一种异质的非霍奇金淋巴瘤.
- 高基-67增殖指数在DLBCL中很常见.
- 预后因素包括阶段,LDH和代谢性瘤体积.
- 从症状开始到诊断对DLBCL结果的时间的影响也在争论中.
研究的目的:
- 为了评估DLBCL的诊断途径.
- 评估诊断时间表对治疗结果的影响.
- 确定影响无进展生存 (PFS) 的特定时间间隔.
主要方法:
- 160名DLBCL患者的前性研究.
- 诊断时间表的评估:症状发作到医疗保健联系,症状发作到活检,活检到治疗开始.
- 时间间隔与国际预测指数 (IPI) 和PFS的相关性.
主要成果:
- 从症状发作到治疗 (TST) 的平均时间为146天.
- 长时间的TST (>3个月) 与更高的IPI相关.
- 从活检到治疗 (TBT) 的时间延长 (>2周) 与更好的绩效状态和更低的IPI相关.
- 从症状出现到诊断活检 (>7周) 的时间延长与较低的PFS相关 (p=0.012).
- 这种效应在高Ki67 DLBCL (p<0.001) 中更为明显.
- 较长的TBT (>2周) 与低增殖瘤中更好的PFS相关 (p=0.032).
结论:
- 诊断延迟,特别是在活检之前,对DLBCL的PFS产生负面影响,特别是在高增殖亚型中.
- 治疗时间和结果之间的关系是复杂的,并且取决于亚型.
- 优化诊断时间表可能会改善DLBCL患者的治疗结果.
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