摘要目的:对就诊于我院的初治血管免疫母细胞性T细胞淋巴瘤（AITL）患者进行回顾性研究，探讨AITL患者的临床特征及影响预后的因素。方法:收集2009年7月至2018年9月就诊于福建医科大学附属协和医院，经淋巴结病理及免疫组织化学检查确诊为AITL患者的临床资料，采用Log-rank检验及Cox比例风险回归模型分析影响患者总生存（OS）期和无进展生存（PFS）期的预后因素。结果:纳入患者84例，中位发病年龄62（39~86）岁，年龄>60岁者44例（52.4%），男60例（71.4%），男女比例2.5∶1，Ann Arbor分期Ⅲ~Ⅳ期者80例（95.2%），伴B症状者53例（63.1%）。国际预后指数（IPI）评分0~2分者25例（29.8%），3~5分者59例（70.2%）。外周T细胞淋巴瘤预后指数（PIT）评分0~1分者42例（50.0%），2~4分者42例（50.0%）。可评估疗效的61例患者中有16例（26.2%）获得完全缓解/不确定的完全缓解，25例（41.0%）获得部分缓解，总体反应率为67.2%，5年OS率和PFS率分别为46.0%和38.3%。单因素分析显示，年龄、IPI评分、PIT评分、HGB水平、是否有浆膜腔积液、是否化疗对AITL的OS有预后意义，而年龄>60岁、HGB<110 g/L及存在浆膜腔积液是影响PFS的不良因素。多因素分析显示，年龄>60岁、有浆膜腔积液是OS的独立不良预后因素。结论:AITL是一种侵袭性高、进展快、预后差的非霍奇金淋巴瘤，初诊时多为Ⅲ~Ⅳ期。治疗前的年龄、IPI评分、PIT评分、HGB水平及是否有浆膜腔积液可作为评价预后的参考指标。

abstractsObjective:In order to clarify the clinical characteristics and prognostic factors of AITL, we performed a retrospective analysis on the AITL patients at our hospital.Methods:The clinical data of 84 AITL patients diagnosed by lymph node pathology and immunohistochemistry in the Fujian Medical University Union Hospital between July 2009 and September 2018 were collected, and the prognostic factors affecting overall survivol (OS) and progression-free surrival (PFS) were retrospectively analyzed by Log-rank test and Cox progortional hazard regression model.Results:The median age of the 84 patients was 62 y (range, 39-86 y) with 52.4% of the patients aged >60 y. The male-to-female ratio was 2.5∶1. 80 patients (95.2%) presented with advanced-stage disease, and B symptoms were observed in 53 cases (63.1%) . Fifty-nine patients (70.2%) had intermediate high and high risk as per the international prognostic index (IPI) and 42 (50.0%) had intermediate high risk as per the prognostic index for peripheral T-cell lymphoma (PIT) . The treatment response could be evaluated in 61 of the 67 patients who underwent chemotherapy. The complete remission (CR/CRu) rate was 26.2% (16/61) , and the partial response rate was 41.0% (25/61) . The 5-year OS rate and PFS rate in 61 patients was 46.0% and 38.3%, respectively. The univariate analysis showed that age, IPI score, PIT score, hemoglobin level, presence of serous effusions, and chemotherapy influenced the OS. Age >60 y, hemoglobin level <110 g/L, and presence of serous effusions were poor prognostic factors for PFS. Multivariate analysis showed that age >60 y and serous effusion were independent poor prognostic factors of OS.Conclusions:AITL is a Non-Hodgkin lymphoma with high invasion, rapid progress, and poor prognosis. The age, IPI score, PIT score, hemoglobin levels, and serous effusion can be used as reference factors for predicting the prognosis in AITL patients.