Li Na, Jiang Ming, Wu Wan-Chun, Wei Wen-Wen, Zou Li-Qun
Department of Medical Oncology of Cancer Center, West China Hospital, Sichuan University, Chengdu, China.
Department of Oncology, West China Fourth Hospital, Sichuan University, Chengdu, China.
Front Oncol. 2021 Aug 18;11:704962. doi: 10.3389/fonc.2021.704962. eCollection 2021.
Nasal-type, extranodal nature killer (NK)/T-cell lymphoma-associated hemophagocytic syndrome (NK/T-LAHS) is a rare and life-threatening disease, requiring investigation of risk stratification. We conducted a retrospective study and proposed nomograms to predict NK/T-LAHS. The discriminative ability and calibration of the nomograms for prediction were tested using C statistics and calibration plots. We analyzed 533 patients with extranodal NK/T-cell lymphoma (ENKTL), out of which 71 were diagnosed with hemophagocytic syndrome (HPS), with a cumulative incidence of 13.3%. Significant difference for 2-year survival was found between patients with and without HPS (14.7% 77.5%). Analyses showed that Eastern Cooperative Oncology Group (ECOG) performance status (PS) ≥2, B symptoms, and bone marrow (BM) invasion were significantly associated with NK/T-LAHS. We used these data as the basis to establish a nomogram of risk index for ENKTL (RINK). In 335 patients with available data for Epstein-Barr virus DNA (EBV-DNA), we found high viral copies (≥4,450 copies/ml) were correlated with NK/T-LAHS. When these data were added to RINK, we developed another nomogram that included EBV-DNA data (RINK-E). The nomograms displayed good accuracy in predicting NK/T-LAHS with a C-statistics of 0.919 for RINK and a C-statistics of 0.946 for RINK-E, respectively. The calibration chart also showed an excellent consistency between the predicted and observed probabilities. The proposed nomograms provided individualized risk estimate of HPS in patients with ENKTL.
鼻型、结外自然杀伤（NK）/T细胞淋巴瘤相关噬血细胞综合征（NK/T-LAHS）是一种罕见且危及生命的疾病，需要对风险分层进行研究。我们进行了一项回顾性研究并提出列线图以预测NK/T-LAHS。使用C统计量和校准图对预测列线图的判别能力和校准进行了测试。我们分析了533例结外NK/T细胞淋巴瘤（ENKTL）患者，其中71例被诊断为噬血细胞综合征（HPS），累积发病率为13.3%。有HPS和无HPS的患者之间2年生存率存在显著差异（14.7%对77.5%）。分析表明，东部肿瘤协作组（ECOG）体能状态（PS）≥2、B症状和骨髓（BM）侵犯与NK/T-LAHS显著相关。我们以这些数据为基础建立了ENKTL风险指数列线图（RINK）。在335例有可用爱泼斯坦-巴尔病毒DNA（EBV-DNA）数据的患者中，我们发现高病毒拷贝数（≥4450拷贝/ml）与NK/T-LAHS相关。当将这些数据添加到RINK中时，我们开发了另一个包含EBV-DNA数据的列线图（RINK-E）。RINK和RINK-E列线图在预测NK/T-LAHS方面显示出良好的准确性，C统计量分别为0.919和0.946。校准图也显示预测概率和观察概率之间具有良好的一致性。所提出的列线图为ENKTL患者的HPS提供了个体化风险估计。
