Value of lymphocyte subsets in assessing the prognosis of adult hemophagocytic syndrome
10.3760/cma.j.cn114452-20211022-00654
- VernacularTitle:淋巴细胞亚群检测在评估成人噬血细胞综合征预后中的价值
- Author:
Ziyuan SHEN
1
;
Chenlu HE
;
Ying WANG
;
Qian SUN
;
Qinhua LIU
;
Ruixiang XIA
;
Hao ZHANG
;
Yuqing MIAO
;
Hao XU
;
Weiying GU
;
Chunling WANG
;
Yuye SHI
;
Jingjing YE
;
Chunyan JI
;
Taigang ZHU
;
Dongmei YAN
;
Wei SANG
;
Kailin XU
;
Shuiping HUANG
;
Xiangmin WANG
Author Information
1. 徐州医科大学公共卫生学院 流行病与卫生统计学（2019级），徐州 221004
- Keywords:
Lymphocyte subsets;
Hemophagocytic syndrome;
Fibrinogen;
Prognostic analysis
- From:
Chinese Journal of Laboratory Medicine
2022;45(9):914-920
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the prognostic value of lymphocyte subsets in adult hemophagocytic syndrome (HPS).Methods:A total of 172 adult HPS patients diagnosed in 8 medical centers from January 2013 to August 2020 were selected for the study, of whom 87 were male (50.6%, 87/172), and 85 were female (49.4%, 85/172), with 68 survivors and 104 deaths. The clinical data were summarized, and variables such as lymphocyte subsets, immunoglobulin characteristics and fibrinogen were retrospectively analyzed, and the correlation between the mentioned variables and patient prognosis was analyzed. The optimal cut-off values of continuous variables were calculated by MaxStat, and the prognostic factors of HPS patients were screened based on the Cox proportional hazard regression model.Results:The median age of HPS patients was 56 (42, 66) years old, and the 5-year cumulative survival rate was 37.4% (37.4/100). The median age, platelet and albumin were 48 (27, 63) years, 84×10 9/L and 32.3 g/L in the survival group, and 59 years, 45.5×10 9/L, and 27.3 g/L in the death group, respectively. The differences between the two groups was statistically significant ( Z=?3.368, P=0.001; Z=?3.156, P=0.002; Z=?3.431, P=0.001). Patients with differentiated cluster 8+(CD8+)<11.1%, CD3+<64.9%, CD4+>51%, and CD4/CD8 ratio>2.18 had poor prognosis (χ 2=7.498, P=0.023; χ 2=4.169, P=0.041; χ 2=4.316, P=0.038; χ 2=9.372, P=0.002). Multivariable analysis showed that CD4/CD8 ratio, age, fibrinogen and hemoglobin were independent prognostic factors in HPS patients ( HR=2.435, P=0.027; HR=5.790, P<0.001; HR=0.432, P=0.018; HR=0.427, P=0.018). Conclusion:Peripheral blood lymphocyte subsets can be used to evaluate the prognosis of patients with HPS; CD4/CD8 ratio, age, fibrinogen, and hemoglobin are independent prognostic factors in HPS patients.
