预后营养指数（PNI）对新诊断弥漫性大B细胞淋巴瘤患者的价值：基于倾向评分匹配分析的HHLWG多中心回顾性研究

The Value of Prognostic Nutritional Index (PNI) on Newly Diagnosed Diffuse Large B-Cell Lymphoma Patients: A Multicenter Retrospective Study of HHLWG Based on Propensity Score Matched Analysis.

作者信息

Shen Ziyuan, Wang Fei, He Chenlu, Li Dashan, Nie Shanlin, Bian Zhenzhen, Yao Mingkang, Xue Yuhao, Wang Ying, Gu Weiying, Zhu Taigang, Shi Yuye, Zhang Hao, Huang Shuiping, Miao Yuqing, Sang Wei

机构信息

Department of Epidemiology and Biostatistics, Xuzhou Medical University, Xuzhou, Jiangsu, People's Republic of China.

Department of Hematology, The First People's Hospital of Changzhou, Changzhou, Jiangsu, People's Republic of China.

出版信息

J Inflamm Res. 2021 Oct 27;14:5513-5522. doi: 10.2147/JIR.S340822. eCollection 2021.

INTRODUCTION

Immunonutritional status is associated with the survival of DLBCL. This multicenter retrospective study aimed to explore the prognostic value of Prognostic Nutrition Index (PNI) in DLBCL patients by using propensity score matched analysis (PSM).

METHODS

A total of 990 DLBCL cases were recruited from 5 centers of Huaihai Lymphoma Working Group (HHLWG). A 1:1 PSM analysis was performed using the nearest-neighbor method, with a caliper size of 0.02. Cox regression analysis was used to examine factors associated with survival.

RESULTS

The median age at diagnosis was 62 years and 52.5% were males, with the 3-y overall survival of 65.1%. According to the MaxStat analysis, 44 was the optimal cut-off point of PNI. After PSM analysis, a total of 282 patients in PNI < 44 group could be propensity matched to PNI ≥ 44 patients, creating a group of 564 patients. Multivariable analysis revealed that PNI, age, central nervous system involvement and International Prognostic Index (IPI) were independent prognostic factors for DLBCL. Kaplan-Meier analysis indicated that patients with low PNI in Ann Arbor Stage (III/VI), ECOG (<2), IPI (LR+LIR), GCB, and BCL-2 negative groups had a poor prognosis.

DISCUSSION

PNI could accurately stratify the prognosis of DLBCL after PSM analysis.

引言

免疫营养状态与弥漫性大B细胞淋巴瘤（DLBCL）的生存相关。本多中心回顾性研究旨在通过倾向评分匹配分析（PSM）探讨预后营养指数（PNI）在DLBCL患者中的预后价值。

方法

从淮海淋巴瘤工作组（HHLWG）的5个中心招募了990例DLBCL病例。使用最近邻法进行1:1的PSM分析，卡尺大小为0.02。采用Cox回归分析来检验与生存相关的因素。

结果

诊断时的中位年龄为62岁，男性占52.5%，3年总生存率为65.1%。根据MaxStat分析，44是PNI的最佳切点。经过PSM分析，PNI<44组的282例患者可与PNI≥44的患者进行倾向匹配，形成一组564例患者。多变量分析显示，PNI、年龄、中枢神经系统受累情况和国际预后指数（IPI）是DLBCL的独立预后因素。Kaplan-Meier分析表明，Ann Arbor分期（III/VI期）、美国东部肿瘤协作组（ECOG）评分（<2）、IPI（LR+LIR）、生发中心B细胞（GCB）和BCL-2阴性组中PNI低的患者预后较差。