ABSTRACT
Objective: To investigate the clinical characteristics, treatment regimens, and outcomes of patients with primary breast dif-fuse large B-cell lymphoma (PB-DLBCL). Methods: Between January 2010 and January 2018, 21 patients with PB-DLBCL were diag-nosed, treated, and followed up at the First Affiliated Hospital of Zhengzhou University. All patients were female, with a median age of 49 years (ranging from 21 to 77 years) at presentation. All patients received chemotherapy, of which 17 patients received the CHOP regimen and 4 received the EPOCH regimen. Eight patients received chemotherapy followed by radiotherapy, and 13 received chemo-therapy alone. Six patients received prophylactic intrathecal injections. The incidences of refractory and progressive disease between patients who received different regimens were analyzed using the Chi-square test. The overall survival (OS) and progression-free sur-vival (PFS) rates were calculated using the Kaplan-Meier method, and differences in survival were compared using the Log-rank test. Multivariate analysis was performed with the Cox-regression model for those factors that were confirmed as significant in the univari-ate analysis. Results: The most common presentation was a painless mass. The 5-year OS and PFS rates were 74% and 66%, respective-ly. There was no significant difference in the incidence of refractory or progressive disease between the EPOCH and CHOP groups (P=0.603). Six of those who received prophylactic intrathecal injections had no central nervous system recurrence, and 2 patients who did not receive prophylactic intrathecal injections had central nervous system recurrence. Univariate and multivariate analyses showed that both the level of serum β2 microglobulin [P=0.044, hazard ratio (HR)=0.431, 95% confidence interval (CI): 0.432-0.967] and radio-therapy (P=0.002, HR=0.495, 95% CI: 1.073-2.508) were related to the OS of PB-DLBCL. Conclusions: PB-DLBCL often occurs in women, mostly involving the unilateral breast, which manifests mainly as a painless mass. The level of serum β2 microglobulin is a factor of poor prognosis in PB-DLBCL. The treatment modality of chemotherapy combined with radiotherapy can significantly improve the OS of PB-DLBCL. Prophylactic intrathecal injections may be useful to reduce the incidence of refractory disease or recurrence in the central nervous system.
ABSTRACT
Objective To study the effect of serum β2 micro-globulin(β2-MG) level change on the diagnostic efficiency of renal damage .Methods A total of 254 cases of hepatorenal diseases in our hospital from October 2015 to October 2016 were selected and divided into the liver damage group(87 cases) ,renal damage group(113 cases) and hepatorenal damage group(54 cases) according to the hepatorenal function .Contemporaneous 85 cases undergoing healthy physical examination were collected as the control group .The levels of ALT ,AST ,β2-MG and creatinine(Cr) were detected in each group .Results There was no correlation between the serum ALT level and serum β2-MG level in liver damage group(r=0 .046 ,P=0 .674) ,while the serum AST level was correla-ted with the serum β2-MG level(r=0 .251 ,P=0 .020) ,the ASL/ALT ratio was correlated with the serum β2-MG level(r=0 .633 , P=0 .000);the serum β2-MG level in the liver damage group was significantly higher than that in the control group (Z= -9 .418 , P=0 .000) ,the Cr/β2-MG ratio was lower than that in the control group (Z= -2 .779 ,P=0 .005) ,and the Cr/β2-MG ratio in the hepatorenal damage group was lower that in the renal damage group (Z= -1 .487 ,P=0 .137) .The receiver operating characteristic curve analysis showed that the area under curve(AUC) ,cutoff value ,standard error ,95% confidence interval(CI) ,specificity and sensitivity of β2-MG were 0 .970 ,2 .61 μg/L ,0 .012 ,0 .946 -0 .994 ,0 .988 and 0 .852 in the renal damage group and 0 .832 ,4 .26μg/L ,0 .04 ,0 .755-0 .910 ,0 .862 and 0 .741 in the hepatorenal damage group respectively .Conclusion Hepatorenal damage mainly affects the diagnosis of serum β2-MG on mild renal damage .