绝对淋巴细胞计数/绝对单核细胞计数比值、可溶性白细胞介素 2 受体水平、血清程序性细胞死亡蛋白 1 水平与弥漫性大 B 细胞淋巴瘤患者预后的关系。

Relationship between the absolute lymphocyte count/absolute monocyte count ratio, soluble interleukin 2 receptor level, serum programmed cell death 1 level, and the prognosis of patients with diffuse large B-cell lymphoma.

机构信息

Department of Hematology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.

Stem Cell and Regenerative Medicine Research Center, Sichuan Neo-life Stem Cell Biotech Inc., Chengdu, China.

出版信息

Ann Palliat Med. 2021 Oct;10(10):10938-10945. doi: 10.21037/apm-21-2551.

DOI:10.21037/apm-21-2551

PMID:34763456

Abstract

BACKGROUND

To analyze the relationship between the peripheral blood absolute lymphocyte count (ALC)/absolute monocyte count (AMC) ratio, soluble interleukin 2 receptor (sIL-2R) level, serum programmed cell death 1 (PD-1) level, and the prognosis of patients with diffuse large B-cell lymphoma (DLBCL).

METHODS

A total of 78 patients with DLBCL admitted to hospital and 30 healthy controls were enrolled as the case group and control group between August 2019 and June 2020, respectively. The ALC/AMC ratio and the levels of sIL-2R and serum PD-1 between the 2 groups and among patients with different prognoses were compared. The evaluation efficiency of these 3 factors for the prognosis of DLBCL patients was analyzed by receiver operating characteristic (ROC) curves. The risk factors affecting the 1-year survival rate were analyzed by the Cox hazard model.

RESULTS

The levels of sIL-2R, AMC, and PD-1 in the case group were significantly higher than those in the control group, while the ALC/AMC ratio was lower than that in the control group (P<0.05). The levels of sIL-2R and PD-1 in the poor prognosis group were significantly higher than those in the good prognosis group, while the ALC/AMC ratio was lower than that in the good prognosis group (P<0.05). The areas under the ROC curve (AUCs) of sIL-2R level, serum PD-1 level, and the ALC/AMC ratio in evaluating the prognosis of DLBCL patients were 0.805 (95% CI: 0.700-0.886), 0.825 (95% CI: 0.722-0.902), 0.792 (95% CI: 0.685-0.876), respectively. The critical values were 474.80 µg/L, 206.85 pg/mL and 3.01, respectively. The differences in the 1-year survival rate among DLBCL patients with different tumor sizes, B symptoms, sIL-2R levels, and ALC/AMC ratios were statistically significant (P<0.05). B symptoms (RR =1.721) and ALC/AMC ratio lower than 3.01 (RR =1.484) were independent influencing factors of the 1-year survival rate in DLBCL patients (P<0.05).

CONCLUSIONS

The ALC/AMC ratio, sIL-2R level, and serum PD-1 level can effectively assess the prognosis of DLBCL patients. B symptoms and ALC/AMC ratio lower than 3.01 are risk factors affecting the 1-year survival rate of patients.

摘要

背景

分析外周血绝对淋巴细胞计数（ALC）/绝对单核细胞计数（AMC）比值、可溶性白细胞介素 2 受体（sIL-2R）水平、血清程序性死亡 1（PD-1）水平与弥漫性大 B 细胞淋巴瘤（DLBCL）患者预后的关系。

方法

选取 2019 年 8 月至 2020 年 6 月间医院收治的 78 例 DLBCL 患者为病例组，同期选取 30 例健康体检者为对照组，比较两组间及不同预后患者间的 ALC/AMC 比值、sIL-2R 及血清 PD-1 水平，采用受试者工作特征（ROC）曲线分析这 3 项因素对 DLBCL 患者预后的评估效能，采用 Cox 风险模型分析影响患者 1 年生存率的危险因素。

结果

病例组患者 sIL-2R、AMC 及 PD-1 水平均明显高于对照组，ALC/AMC 比值明显低于对照组（P<0.05）；预后不良组患者 sIL-2R 及 PD-1 水平均明显高于预后良好组，ALC/AMC 比值明显低于预后良好组（P<0.05）。sIL-2R 水平、血清 PD-1 水平、ALC/AMC 比值评估 DLBCL 患者预后的 ROC 曲线下面积（AUC）分别为 0.805（95%CI：0.700~~0.886）、0.825（95%CI：0.722~~0.902）、0.792（95%CI：0.685~0.876），临界值分别为 474.80μg/L、206.85pg/mL、3.01。不同肿瘤直径、B 症状、sIL-2R 水平、ALC/AMC 比值的 DLBCL 患者 1 年生存率比较，差异均有统计学意义（P<0.05）。B 症状（RR=1.721）和 ALC/AMC 比值低于 3.01（RR=1.484）是 DLBCL 患者 1 年生存率的独立影响因素（P<0.05）。