2026 年第 4 期 第 21 卷

C反应蛋白与白蛋白比值和铁蛋白与B细胞非霍奇金淋巴瘤患者临床病理特征及预后的关系

Correlation between C-reactive protein to albumin ratio, ferritin and clinicopathological features as well as prognosis in patients with B-cell non-Hodgkin lymphoma

作者：赵田华李娅黎超刘晶晶李文静侯兰芬

英文作者：Zhao Tianhua Li Ya Li Chao Liu Jingjing Li Wenjing Hou Lanfen

单位：中国人民解放军联勤保障部队第九八〇医院血液科，石家庄050000

英文单位：Department of Hematology the 980th Hospital of Joint Logistics Support Force of the Chinese People′s Liberation Army Shijiazhuang 050000 China

关键词：B细胞非霍奇金淋巴瘤；临床病理特征；预后；C反应蛋白与白蛋白比值；铁蛋白

英文关键词：B-cellnon-Hodgkinlymphoma;Clinicopathologicalfeatures;Prognosis;C-reactiveproteintoalbuminratio;Ferritin

• 摘要：

• 目的 探究C反应蛋白与白蛋白比值（CAR）、铁蛋白与B细胞非霍奇金淋巴瘤（B-NHL）患者临床病理特征及预后的关系。 方法 纳入2021年5月至2023年5月于中国人民解放军联勤保障部队第九八〇医院确诊并接受规范治疗的175例B-NHL患者。将大于等于CAR最佳截断值的患者纳入高CAR组（82例），小于CAR最佳截断值的患者纳入低CAR组（93例）。将大于等于铁蛋白最佳截断值的患者纳入高铁蛋白组（79例），小于铁蛋白最佳截断值的患者纳入低铁蛋白组（96例）。比较不同CAR、铁蛋白组间患者性别、年龄、病理类型、Ann Arbor分期等临床病理特征的差异。Kaplan-Meier法绘制生存曲线，并采用Log-rank检验比较组间差异。Cox比例风险回归分析评估CAR、铁蛋白是否为B-NHL患者短期预后的独立预测因子。结果 高CAR组和低CAR组年龄、Ann Arbor分期、国际预后指数（IPI）评分、B症状、乳酸脱氢酶（LDH）比较差异均有统计学意义（均P＜0.05）。高铁蛋白组和低铁蛋白组Ann Arbor分期、IPI评分、血红蛋白水平比较差异均有统计学意义（均P＜0.05）。Kaplan-Meier法结果显示，高CAR组、高铁蛋白组的B-NHL患者治疗结束后2年累积无进展生存率分别为58.5%和55.7%，低于低CAR组、低铁蛋白组的77.4%和79.2%（P=0.007、0.001）。Cox比例风险回归分析结果显示，Ann Arbor分期Ⅲ~Ⅳ期、IPI评分3~5分、LDH≥250 U/L、高CAR、高铁蛋白均是B-NHL患者短期预后不良的独立预测因子（均P＜0.05）。结论 高CAR、高铁蛋白与B-NHL患者Ann Arbor分期Ⅲ~Ⅳ期、高IPI评分等不良临床病理特征相关，还可独立预测患者短期复发风险。

• Objective To investigate the correlation between C-reactive protein to albumin ratio (CAR), ferritin and clinicopathological features as well as prognosis in patients with B-cell non-Hodgkin lymphoma (B-NHL). Methods A total of 175 B-NHL patients diagnosed and treated standardizedly in the 980th Hospital of Joint Logistics Support Force of the Chinese People′s Liberation Army from May 2021 to May 2023 were enrolled. Patients with CAR ≥ the optimal cut-off value were assigned to the high CAR group (82 cases), and those with CAR ＜ the optimal cut-off value were assigned to the low CAR group (93 cases). Patients with ferritin ≥ the optimal cut-off value were assigned to the high ferritin group (79 cases), and those with ferritin ＜ the optimal cut-off value were assigned to the low ferritin group (96 cases). Differences in clinicopathological features such as gender, age, pathological type and Ann Arbor stage were compared among patients in different CAR and ferritin groups. Kaplan-Meier method was used to plot survival curves, and Log-rank test was used to compare differences between groups. Cox proportional hazards regression analysis was used to evaluate whether CAR and ferritin were independent predictors of short-term prognosis in B-NHL patients. Results There were statistically significant differences in age, Ann Arbor stage, international prognostic index (IPI) score, B symptoms and lactate dehydrogenase (LDH) level between the high CAR group and the low CAR group (all P＜0.05). There were statistically significant differences in Ann Arbor stage, IPI score and hemoglobin level between the high ferritin group and the low ferritin group (all P＜0.05). Kaplan-Meier analysis showed that the 2-year cumulative progression-free survival rates of B-NHL patients in the high CAR group and high ferritin group after treatment were 58.5% and 55.7% respectively, which were lower than those in the low CAR group and low ferritin group (77.4% and 79.2%, P=0.007, 0.001). Cox proportional hazards regression analysis showed that Ann Arbor stage Ⅲ-Ⅳ, IPI score 3-5, LDH ≥250 U/L, high CAR and high ferritin were all independent predictors of poor short-term prognosis in B-NHL patients (all P＜0.05). Conclusion High CAR and high ferritin are correlated with adverse clinicopathological features such as Ann Arbor stage Ⅲ-Ⅳ and high IPI score in B-NHL patients, and can also independently predict the risk of short-term recurrence in patients.