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中国癌症防治杂志

中国癌症防治杂志 ›› 2026, Vol. 18 ›› Issue (1): 28-35.doi: 10.3969/j.issn.1674-5671.2026.01.04

• 论著 • 上一篇    下一篇

淋巴细胞绝对值在接受PD-1单抗治疗的NK/T细胞淋巴瘤患者中的预后价值

  

  1. 首都医科大学附属北京同仁医院血液科

  • 出版日期:2026-02-25 发布日期:2026-03-26
  • 通讯作者: 王亮 E-mail：wangliangtrhos@126.com
  • 基金资助:
    国家自然科学基金面上项目（82370188）；四大慢病重大专项（2025ZD0544300）

Prognostic value of absolute lymphocyte count in patients with NK/T-cell lymphoma receiving PD-1 monoclonal antibody therapy

  • Online:2026-02-25 Published:2026-03-26

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摘要： 目的 探讨淋巴细胞绝对值（absolute lymphocyte count，ALC）在接受程序性死亡受体⁃1（programmed death⁃1，PD⁃1）单抗治疗自然杀伤/T细胞淋巴瘤（NK/T cell lymphoma, NKTCL）患者中的预后价值，并构建预测无进展生存期（progression⁃free survival, PFS）的预后模型。方法 纳入2019年6月至2023年6月于首都医科大学附属北京同仁医院确诊NKTCL并接受PD⁃1单抗联合治疗的患者41例。基于最大选择秩统计量确定ALC的最佳截断值，采用Cox比例风险回归模型分析ALC与预后的关联，基于预后因素构建预后评分模型。结果 ALC的最佳截断值为1.35×10⁹/L。低ALC组与高ALC组的PFS及总生存期（overall survival,OS）差异有统计学意义（均P<0.001），高ALC组中位PFS为216 d，中位OS为343 d，低ALC组中位PFS及OS均未达到。多因素分析显示，ALC≥1.35×109/L是患者PFS的独立影响因素（HR=3.185，95%CI：1.146~8.851）。基于年龄、疾病状态、Ann Arbor分期系统和ALC构建的评分模型可有效区分低危与高危患者，其预测PFS的曲线下面积为0.924，高于传统列线力图修订版风险指数（nomogram⁃revised risk index，NRI）评分的0.545（P<0.001）。低危组临床获益率为83.3%，显著高于高危组43.5%（P=0.012）。结论 治疗前ALC是PD⁃1单抗联合治疗NKTCL患者PFS的独立预后因子。基于年龄、疾病状态、分期及ALC构建的预后模型有助于更精准地评估患者风险分层，指导个体化治疗。 

关键词: NK/T细胞淋巴瘤, PD?1单抗, 淋巴细胞绝对值, 预后因素, 预后模型

Abstract: Objective To investigate the prognostic value of absolute lymphocyte count (ALC) in patients with natural killer/T⁃cell lymphoma (NKTCL) treated with programmed death⁃1 (PD⁃1) inhibitor, and to develop a prognostic model for predicting progression⁃free survival (PFS). Methods A cohort of 41 patients with NKTCL who underwent PD⁃1 inhibitor combination therapy at Beijing Tongren Hospital, Capital Medical University from June 2019 to June 2023 were enrolled. The optimal cut⁃off value for ALC was determined using the maximum selected rank statistics. The Cox proportional hazards regression model was used to analyze the correlation between ALC and prognosis, and a prognostic scoring model was constructed based on the identified prognostic factors. Results The optimal cut⁃off value of ALC was 1.35×10⁹/L. Significant differences in PFS and overall survival (OS) were observed between the low ALC group and high ALC group (P<0.001). The median PFS and median OS in the high ALC group were 216 days and 343 days, respectively, whereas both median PFS and OS were not reached in the low ALC group. Multivariable analysis demonstrated that ALC ≥1.35×109/L was an independent prognostic factor for PFS (HR=3.185, 95%CI: 1.146-8.851). The scoring model constructed based on age, disease status, Ann Arbor staging system and ALC could effectively distinguish low⁃risk from high⁃risk patients, with an area under the curve (AUC) of 0.924 for predicting PFS, which was significantly higher than that of the conventional nomogram⁃revised risk index (NRI) score (0.545, P<0.001). The clinical benefit rate (CBR) of the low⁃risk group reached 83.3%, significantly exceeding the 43.5% observed in the high⁃risk group (P=0.012). Conclusions Pretreatment ALC is an independent prognostic factor for PFS in NKTCL patients receiving PD⁃1 inhibitor combination therapy. The novel prognostic model integrating age, disease status, Ann Arbor stage and ALC improves risk stratification and may inform individualized treatment strategies.

Key words: NK/T cell lymphoma, PD?1 monoclonal antibody, Absolute lymphocyte count, Prognostic factor, Prognostic model<

中图分类号: 

  • R733.4