Hao Xiaoxiao, Wei Yongqiang, Wei Xiaolei, Zhou Lizhi, Wei Qi, Zhang Yuankun, Huang Weimin, Feng Ru
Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou, China.
Oncotarget. 2017 Sep 11;8(44):76740-76748. doi: 10.18632/oncotarget.20832. eCollection 2017 Sep 29.
Inflammation-based prognostic scores, such as the glasgow prognostic score (GPS), prognostic index (PI), prognostic nutritional index (PNI), neutrophil lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR) were related to survival in many solid tumors. Recent study showed that GPS can be used to predict outcome in diffuse large B-cell lymphoma (DLBCL). However, other inflammation related scores had not been reported and it also remained unknown which of them was the most useful to evaluate the survival in DLBCLs. In this retrospective study, a number of 252 newly diagnosed and histologically proven DLBCLs from January 2003 to December 2014 were included. The high GPS, high PI, high NLR, high PLR and low PNI were all associated with poor overall survival ( < 0.05) and event-free survival ( < 0.05) in univariate analysis. Multivariate analysis indicated that GPS (HR = 1.781, 95% CI = 1.065-2.979, = 0.028) remained an independent prognostic predictor in DLBCL. The c-index of GPS (0.735, 95% CI = 0.645-0.824) was greater than that of PI (0.710, 95% CI = 0.621-0.799, = 0.602), PNI (0.600, 95% CI = 0.517-0.683, = 0.001), PLR (0.599, 95% CI = 0.510-0.689, = 0.029) and NLR (0.572, 95% CI = 0.503-0.642, = 0.005) by Harrell's concordance index. Especially in DLBCLs treated with R-CHOP, GPS still remained the most powerful prognostic score when comparing with others ( = 0.001 and < 0.001, respectively for OS and EFS). In conclusion, it is indicated that inflammation-based prognostic scores such as GPS, PI, NLR, PNI and PLR all could be used to predict the outcome of DLBCLs. Among them, GPS is the most powerful indicator in predicting survival in DLBCLs, even in the rituximab era.
基于炎症的预后评分，如格拉斯哥预后评分（GPS）、预后指数（PI）、预后营养指数（PNI）、中性粒细胞淋巴细胞比值（NLR）和血小板淋巴细胞比值（PLR），与许多实体瘤的生存情况相关。最近的研究表明，GPS可用于预测弥漫性大B细胞淋巴瘤（DLBCL）的预后。然而，其他与炎症相关的评分尚未见报道，且哪种评分对评估DLBCL的生存情况最有用也尚不清楚。在这项回顾性研究中，纳入了2003年1月至2014年12月期间新诊断且经组织学证实的252例DLBCL患者。单因素分析显示，高GPS、高PI、高NLR、高PLR和低PNI均与总生存期差（P<0.05）和无事件生存期差（P<0.05）相关。多因素分析表明，GPS（HR = 1.781，95%CI = 1.065 - 2.979，P = 0.028）在DLBCL中仍是独立的预后预测指标。根据Harrell一致性指数，GPS的c指数（0.735，95%CI = 0.645 - 0.824）大于PI（0.710，95%CI = 0.621 - 0.799，P = 0.602）、PNI（0.600，95%CI = 0.517 - 0.683，P = 0.001）、PLR（0.599，95%CI = 0.510 - 0.689，P = 0.029）和NLR（0.572，95%CI = 0.503 - 0.642，P = 0.005）。特别是在接受R-CHOP治疗的DLBCL患者中，与其他评分相比，GPS在总生存期（P = 0.001）和无事件生存期（P<0.001）方面仍是最有力的预后评分。总之，研究表明基于炎症的预后评分如GPS、PI、NLR、PNI和PLR均可用于预测DLBCL的预后。其中，GPS是预测DLBCL生存情况最有力的指标，即使在利妥昔单抗时代也是如此。
