[肝脏受累的原发性全身轻链淀粉样变性的临床表现和预后分析]。

T T Qiao, Y Liu, N Peng, L Z Gong, X L Dou, L Wen, J Lu
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引用次数: 0

摘要

目的总结一个中心的肝淀粉样变性患者的临床表现和预后因素。方法回顾性分析本中心自2012年10月至2023年1月收治的28例肝脏受累的原发性全身轻链淀粉样变性患者的临床资料。研究了主要临床表现和预后因素。根据不同数据采用χ(2)检验、费雪精确检验、Wilcoxon秩检验或Kaplan-Meier生存曲线对数秩检验进行统计分析。结果肝脏受累患者的主要临床表现为腹胀、肝肿大和水肿。CD56和趋化因子受体4蛋白表达分别占52%(13/25)和56%(14/25)。64.3%(9/14)的患者合并有 t(11,14),21.4%(3/14)的患者 1q21 (+) 阳性,没有患者检出 del(17p)。单变量分析显示,梅奥2004和2012分期以及总胆红素(TBil)≥34.2 μmol/L与无进展生存期和总生存期相关。TBil≥34.2μmol/L 组患者的中位无进展生存期和总生存期(0.178 年、0.195 年)明显低于 TBilP 组:梅奥分期和高胆红素血症是原发性全身轻链淀粉样变性伴肝脏受累患者的不良预后因素。
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[Analysis of clinical manifestations and prognosis of primary systemic light chain amyloidosis with liver involvement].

Objective: To summarize the clinical manifestations and prognostic factors of patients with hepatic amyloidosis in a single center. Methods: The clinical data of 28 primary systemic light chain amyloidosis cases with liver involvement in our center from October 2012 to January 2023 were retrospectively analyzed. The main clinical manifestations and prognostic factors were studied. Statistical analysis were performed using the χ(2) test, Fisher's exact test, Wilcoxon rank test, or Kaplan-Meier survival curve log-rank test according to the different data. Results: The main clinical manifestations of patients with liver involvement were abdominal distension, hepatomegaly, and edema. CD56 and chemokine receptor 4 protein expression accounted for 52% (13/25) and 56% (14/25). 64.3% (9/14) patients were combined with t (11,14), and 21.4% (3/14) patients were positive for 1q21 (+), and no patients were detected with del(17p). Univariate analysis showed that Mayo 2004 and 2012 stages and total bilirubin (TBil) ≥34.2 μmol/L were associated with progression-free survival and overall survival. The median progression-free survival and overall survival were significantly inferior in patients with TBil≥34.2μmol/L group (0.178 years, 0.195 years) than with the TBil<34.2μmol/L group (0.750 years, 3.586 years) (P < 0.05). Conclusion: Mayo stage and hyperbilirubinemia are inferior prognostic factors for patients with primary systemic light chain amyloidosis accompanied with liver involvement.

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来源期刊
中华肝脏病杂志
中华肝脏病杂志 Medicine-Medicine (all)
CiteScore
1.20
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0.00%
发文量
7574
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