Hematology Department, Affiliated Hospital of Jiangnan University, Wuxi, China.
Ann Palliat Med. 2021 Sep;10(9):9650-9659. doi: 10.21037/apm-21-2067.
The international prognostic index (IPI) is widely used as an indicator for evaluating the clinical prognosis of diffuse large B-cell lymphoma (DLBCL). However, more precise prognostic indicators are needed. This study aimed to evaluate the prognostic significance of the advanced lung cancer inflammation index (ALI), prognostic nutritional index (PNI), and systemic immune-inflammation index (SII) in DLBCL.
A total of 117 patients with newly diagnosed DLBCL were included in this study. Receiver operating characteristic (ROC) curve analysis was used to determine the optimal cut-off values for the ALI, PNI, and SII to predict survival, and patients were stratified into high and low groups. Cox regression analysis and the Kaplan-Meier method were used to assess the prognostic ability of these indexes.
The optimal cut-offs for the ALI, PNI, and SII were 31.26, 36.48, and 486.76, respectively. The ALI had the highest area under the curve (AUC). The high ALI or PNI group had better 5-year overall survival (OS) than the low ALI (73% vs. 53%, P<0.001) or PNI (60% vs. 45%, P<0.001) group, and the low SII group had better 5-year OS than the high SII group (67% vs. 62%, P=0.034). Although all 3 parameters were associated with OS in univariate analyses, only the ALI and PNI were independent factors for OS in multivariate analyses. We found that when DLBCL patients were classified according to IPI combined with ALI, PNI, or SII, respectively, there were more obvious differences in OS among different types.
The ALI and PNI may be easily available markers to predict clinical outcomes in DLBCL patients. SII predicted OS only in univariate analysis.
国际预后指数（IPI）广泛用于评估弥漫性大 B 细胞淋巴瘤（DLBCL）的临床预后，但需要更精确的预后指标。本研究旨在评估晚期肺癌炎症指数（ALI）、预后营养指数（PNI）和全身免疫炎症指数（SII）在 DLBCL 中的预后意义。
共纳入 117 例初诊 DLBCL 患者。采用受试者工作特征（ROC）曲线分析确定 ALI、PNI 和 SII 预测生存的最佳截断值，并将患者分为高、低两组。采用 Cox 回归分析和 Kaplan-Meier 法评估这些指标的预后能力。
ALI、PNI 和 SII 的最佳截断值分别为 31.26、36.48 和 486.76，其中 ALI 的曲线下面积（AUC）最高。高 ALI 或 PNI 组的 5 年总生存率（OS）明显优于低 ALI（73%比 53%，P<0.001）或 PNI（60%比 45%，P<0.001）组，低 SII 组的 5 年 OS 明显优于高 SII 组（67%比 62%，P=0.034）。虽然在单因素分析中，所有 3 个参数均与 OS 相关，但在多因素分析中，仅 ALI 和 PNI 是 OS 的独立因素。我们发现，当根据 IPI 结合 ALI、PNI 或 SII 对 DLBCL 患者进行分类时，不同类型患者的 OS 差异更明显。
ALI 和 PNI 可能是预测 DLBCL 患者临床结局的简单易得的标志物。SII 仅在单因素分析中预测 OS。
