Mục tiêu: Đánh giá một số đặc điểm lâm sàng và cận lâm sàng ở bệnh nhân (BN) u lympho ác tính non-Hodgkin (ULATNH) nguyên phát ngoài hạch tại Bộ môn - Trung tâm Nội Dã chiến, Bệnh viện Quân y 103 giai đoạn 2018 - 2024. Phương pháp nghiên cứu: Nghiên cứu hồi cứu, mô tả cắt ngang trên 47 BN được chẩn đoán ULATNH nguyên phát ngoài hạch điều trị tại Bộ môn - Trung tâm Nội Dã chiến, Bệnh viện Quân y 103. Kết quả: Tuổi trung bình là 60,51 ± 15,66; tỷ lệ nam/nữ = 1,35. Thời gian phát hiện bệnh thường < 3 tháng. Triệu chứng thường gặp gồm triệu chứng B (40,4%) và thiếu máu (53,2%). Vị trí tổn thương hay gặp nhất là ở đường tiêu hóa (34,8%). Thể mô bệnh học tế bào B lớn lan tỏa chiếm ưu thế (70,2%). Hầu hết BN thuộc nhóm tiên lượng nguy cơ thấp (59,6%). Có mối liên quan giữa tiên lượng nguy cơ bệnh với thời gian phát hiện bệnh, thể mô bệnh học, giảm albumin máu, nồng độ β2M > 2,22 µg/mL (p < 0,05). Kết luận: Triệu chứng lâm sàng của bệnh ULATNH không đặc hiệu. Thời gian khởi phát bệnh, thể mô bệnh học và nồng độ β2M huyết thanh > 2,22 µg/mL là yếu tố độc lập, có ý nghĩa dự đoán tiên lượng bệnh.

This study aimed to evaluate the diagnostic value of hematological inflammatory indices, including neutrophil-to-lymphocyte ratio (NLR), red cell distribution width (RDW), and aggregate index of systemic inflammation (AISI), for detecting renal involvement in adult patients with immunoglobulin A (IgA) vasculitis. A cross-sectional study was conducted in 67 adult patients with IgA vasculitis (IgAV) and 70 healthy controls at 103 Military Hospital, Vietnam. Compared with healthy controls, patients with IgAV showed higher white blood cell, neutrophil, and monocyte counts, as well as elevated NLR and AISI, and lower hemoglobin levels (all P < .05). Renal involvement was identified in 38.8% of patients. Those with renal involvement had significantly higher RDW, NLR, and AISI than patients without renal involvement. Receiver operating characteristic analysis showed moderate diagnostic performance, with area under the curves (AUCs) of 0.682 for NLR, 0.675 for RDW, and 0.674 for AISI. The combined RDW + NLR model improved diagnostic accuracy (AUC = 0.759, 95% CI: 0.636–0.882), while the RDW + AISI model showed the best performance (AUC = 0.797, 95% CI: 0.684–0.911), with sensitivity of 53.8% and specificity of 95.1% ( P < .001). Univariate analysis showed that elevated RDW, NLR, and AISI were significantly associated with renal involvement. Multivariate logistic regression adjusted for age and sex confirmed these indices as independent predictors. RDW, NLR, and AISI are independently associated with renal involvement in adult IgAV. The combination of RDW and AISI demonstrated the highest diagnostic performance and may serve as a simple, cost-effective tool for identifying patients at increased risk of renal involvement.

Background: Classical Hodgkin lymphoma (cHL) is a rare B-cell malignant neoplasm, characterized by the presence of rare mononucleated Hodgkin and multinucleated Reed–Sternberg cells (HRS). CD34+ cells are highly expressed on lymphoma stem cells in bone marrow (BM). Little is known about gene mutations in BM CD34+ cells of cHL. In this study, whole exome sequencing (WES) was performed and high-frequency mutation genes were examined through their expression levels. Materials and Methods: The influence of the variants on protein function was predicted with in silico tools or public databases. Gene expression levels were determined by quantitative real-time PCR. Results: WES assay from BM CD34+ cells in thirty cHL patients revealed that three variants were detected in known cHL-associated genes, including NCF1 (13.33%), MMP9 (3.33%), and VDR (3.33%). We also observed other candidate genes including CNN2 rs77830704 (76.67%), CNN2 rs78386506 (63.33%), MUC4 p.Y3278_Q3209Del (66.67%), MUC4 p.P1076_P1124Del (33.33%), MUC4 rs748236754 (26.67%), MUC4 p.P1609Ins (23.33%), MUC4 rs748705487 (20%), MUC4 p.P4121_P4137Del (16.67%), MTSS2 rs531163149 (13.33%), KMT2C rs201834857 (20%), HAVCR2 rs184868814 (16.67%), and TCF19 rs541001159 (13.33%). Moreover, the low levels of MUC4 were associated with an increase in neutrophil-to-lymphocyte ratio and the low CNN2 expression group had higher levels of LDH, suggesting that the low expressions of CNN2 and MUC4 might be important risk factors for poor prognosis in cHL. Conclusions: WES revealed significantly mutated genes, most of which were associated with the physiological activation of lymphoma cells. This finding contributed to the identification of novel gene variants that might impact on the function of BM CD34+ cells in cHL patients.