| BackgroundMalignant lymphoma (ML) is an extremely heterogeneous group of diseases regarding biological behavior, pathologic morphology and clinical features. Malignant lymphoma is the most common malignant tumor of the lymphatic system in 60 years In recent 20-30 years, the proportion of elderly malignant lymphoma have raised continuously becaused of intensified Aging population. According to foreign data shows, The incidence of elderly malignant lymphoma have grown from 19/10 thousand to 99/10 million. Such a rapid increase speed has become the fastest ascended malignant tumour in all age class. Whereas also had the similar reports in Shanghai. Malignant lymphoma is divided into non-hodgkin's lymphoma and non-hodgkin's lymphoma Our country is different from Europe and America, the incidence of NHL is 6 times of HL. The highest peak of the age of NHL mainly elderly people, the highest peak of the HL are relatively young age. NHL is majority in China So it requires accurate early diagnosis, staging, efficacy evaluation and prognosis assessment for elderly non-hodgkin's lymphoma patients.Excepting for combination of pathological features of disease, clinical features and imaging examination, some tumor markers show more and more significant value in staging, monitoring disease progression, tumor infiltration, therapeutic response and long-term survival for elderly non-hodgkin's lymphoma, and are widely used in clinical practice. beta-2 microglobulin is not a special TM, and it increases when a person gets ill including tumor. The relationship between serum beta-2 microglobulin level and diseases has been reported at home and abroad. as people living standard rising, there are more and more longevity, Whether the significance of these test index still applied to elderly non-hodgkin's lymphoma patients remained to be further discussed. The serum beta-2 microglobulin level in 100 patients with elderly non-hodgkin's lymphoma was studied retrospectively, analyzing the relationship between the elderly NHL patients serum beta-2 microglobulin level and pathological types, malignant degrees, the clinical stages, B symptoms (unexplained fever>38℃above 3 consecutive days in the night, night sweats, half year unexplained weight loss p 10% of systemic symptom),, bone marrow involvement (see lymphoma cells or the original young lymphocytes in 5%～20%, or between the malignant cells in bone marrow typical of 2%～5%) and short-term curative effect, this paper discusses the clinical significance of serum beta-2 microglobulin for elderly non-hodgkin's lymphoma.ObjectiveThroughout the analysis of the clinical documents of 100 patients who were diagnosed elderly non-hodgkin's lymphoma, we investigated the clinical significance of serum beta-2 microglobulin level in patients with elderly non-hodgkin's lymphoma.Methods1.100 patients in our depatment who were eldered than 60 years old and diagnosed elderly non-hodgkin's lymphoma from 2005.1 to 2010.12 were retrospectively analyzed. All of them took venous blood on an empty stomach to determine the level of serum beta-2 microglobulin.2. According to the patients'different pathological types, the clinical stages, B symptoms,and bone marrow involvement, the relationship of serum beta-2 microglobulin level with elderly non-hodgkin's lymphoma.3. Patients were divided into two groups:nomal serum beta-2 microglobulin level and high serum beta-2 microglobulin level. The therapeutic effect of two groups were compared.4. Statistical analysis:SPSS statistical package program 16.0 were used to analysis. Association between means was tested by t test. Association among means of multi-groups were tested by one-way ANOVA,χ2test for the rates. P<0.05 were deemed significant.Results1.100 older NHL patients, The serum beta-2 microglobulin level of 72 cases of B cell lymphoma and 28 patients of T cell lymphoma patients are 3.01±1.04 and 3.40＝1.28, there was no significant difference between the groups. (t=1.124,P=0.266).2.100 older NHL patients, the serum beta-2 microglobulin level of 27 cases inert lymphoma,63 inasie lymphoma and 10 cases highly invasive lymphoma patients are 3.56±1.30,3.07±1.12 and 4.04±0.00, there are no significant differences among the three group (t=1.397,P=0.262)3.100 older NHL patients, the serum beta-2 microglobulin level of 66 cases clinical stagingⅢ-Ⅳperiod for patients is 4.22±2.35,34 cases clinical stagingⅠ-Ⅱperiod for patients is 3.01±1.07, there was significant difference between the groups. (t=-2.395,P=0.017).the higher rates ofⅢ-Ⅳperiod in 66 cases of 50 cases beta 2 micro globulin level are 75.76%(50/66), the higher rates ofⅠ-Ⅱperiod in 34 cases of 13 cases beta 2 micro globulin level are 38.24%(13/34), there was significant difference between the groups(χ2=13.554, P=0.000).4.100 older NHL patients,The serum beta-2 microglobulin level of 59 patients without B symptoms and 41 patients with B symptoms are 3.10±1.05 and 4.34±1.80, there was significant difference between the groups (t=-2.635, P=0.008)。the higher rates without B symptoms of the 23 patients in 59 cases beta 2 micro globulin level are 38.98%(23/59),but the higher rates with B symptoms of the 33 patients in 41 cases beta 2 micro globulin level are 80.49%(33/41); there was significant difference between the groups (χ2=16.912, P=0.000)。5.100 older NHL patients,The serum beta-2 microglobulin level of 16 cases with bone marrow involvement is 2.67±0.84, and the serum beta-2 microglobulin level of 84 cases without bone marrow involvement is 3.63±1.03, there was significant difference between the groups, the higher rates with bone marrow involvement of the 12 patients in 16 cases beta 2 micro globulin level are 66.67%(12/16),but the higher rates without bone marrow involvement of the 31 patients in 84 cases beta 2 micro globulin level are 36.91%(31/84); there was significant difference between the groups (χ2=7.958, P=0.005)。6.100 older NHL patients, the serum beta 2 micro globulin level of 56 patients is normal, chemotherapy efficiency is 82.14%, and the inefficiency is 17.86%, the serum beta 2 micro globulin level of 44 patients increases, chemotherapy efficiency is 61.36%, and the inefficiency is 38.64%. the serum beta 2 micro globulin level which is normal is higher than the group which is raised in the efficiency ofchemotherapy, there was significant difference between the groups (χ2=7.958, P=0.005)ConclusionThe serum beta-2 microglobulin level and the higher rates are associated with clinical stage, B symptoms and bone marrow involvement of the elderly NHL; but have nothing to do with the pathological type, malignant degree of the elderly NHL. The patients with higher serum beta-2 microglobulin level have worse initial treatment efficacy and poor prognosis. The serum beta-2 microglobulin level can be used as an important assistant index to diagnosing, staging, evaluating efficacy and predicting prognosis in the elderly NHL. |
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