Wu Xiao-Bo, Hou Shu-Ling, Liu Hu
Department of Lymphoma, Cancer Center, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan 030032, Shanxi Province, China.
World J Clin Cases. 2021 Nov 16;9(32):9825-9834. doi: 10.12998/wjcc.v9.i32.9825.
In malignant tumors, inflammation plays a vital role in the development, invasion, and metastasis of cancer cells. Diffuse large B-cell lymphoma (DLBCL), the most common malignant proliferative disease of the lymphatic system, is commonly associated with inflammation. The international prognostic index (IPI), which includes age, lactate dehydrogenase (LDH), number of extranodal lesions, Ann Arbor score, and Eastern Cooperative Oncology Group (ECOG) score, can evaluate the prognosis of DLBCL. However, its use in accurately identifying high-risk patients and guiding treatment is poor. Therefore, it is important to find novel immune markers in predicting the prognosis of DLBCL patients.
To determine the association between the systemic immune inflammation index (SII), ratio of lymphocytes to monocytes (LMR), ratio of LMR to LDH (LMR/LDH), and prognosis of patients with DLBCL.
A total of 68 patients diagnosed with DLBCL, treated in our hospital between January 2016 and January 2020, were included. test, Pearson's correlation, Kaplan Meier curves, and Cox proportional risk regression analysis were used. The differences in the SII, LMR, and LMR/LDH among patients with different clinicopathological features were analyzed. The differences in progression-free survival time among patients with different SII, LMR, and LMR/LDH expressions and influencing factors affecting the prognosis of DLBCL patients, were also analyzed.
The LMR and LMR/LDH in patients with Ann Arbor stage III-IV, ECOG score ≥ 2, and SII, IPI score 2-5 were significantly higher than those of patients with Ann Arbor stage I-II and ECOG score < 2 ( < 0.05). Patients with high SII, LMR, and LMR/LDH had progression-free survival times of 34 mo (95%CI: 32.52-38.50), 35 mo (95%CI: 33.42-36.58) and 35 mo (95%CI: 33.49-36.51), respectively, which were significantly lower than those with low SII, LMR, and LMR/LDH ( < 0.05); the SII, LMR, and LMR/LDH were positively correlated ( < 0.05). Cox proportional risk regression analysis showed that the SII, LMR, and LMR/LDH were influencing factors for the prognosis of DLBCL patients (hazard ratio = 1.143, 1.665, and 1.704, respectively; < 0.05).
The SII, LMR, and LMR/LDH are related to the clinicopathological features of DLCBL, and they also influence the prognosis of patients with the disease.
在恶性肿瘤中，炎症在癌细胞的发展、侵袭和转移中起着至关重要的作用。弥漫性大B细胞淋巴瘤（DLBCL）是淋巴系统最常见的恶性增殖性疾病，通常与炎症相关。国际预后指数（IPI）包括年龄、乳酸脱氢酶（LDH）、结外病变数量、Ann Arbor分期和东部肿瘤协作组（ECOG）评分，可用于评估DLBCL的预后。然而，其在准确识别高危患者和指导治疗方面效果不佳。因此，寻找新的免疫标志物来预测DLBCL患者的预后具有重要意义。
确定全身免疫炎症指数（SII）、淋巴细胞与单核细胞比值（LMR）、LMR与LDH比值（LMR/LDH）与DLBCL患者预后之间的关联。
纳入2016年1月至2020年1月在我院接受治疗的68例确诊为DLBCL的患者。采用t检验、Pearson相关性分析、Kaplan-Meier曲线分析和Cox比例风险回归分析。分析不同临床病理特征患者的SII、LMR和LMR/LDH差异。分析不同SII、LMR和LMR/LDH表达患者的无进展生存时间差异以及影响DLBCL患者预后的因素。
Ann Arbor分期为III-IV期、ECOG评分≥2以及SII、IPI评分为2-5分的患者的LMR和LMR/LDH显著高于Ann Arbor分期为I-II期且ECOG评分<2的患者（P<0.05）。SII、LMR和LMR/LDH高的患者无进展生存时间分别为34个月（95%CI：32.52-38.50）、35个月（95%CI：33.42-36.58）和35个月（95%CI：33.49-36.51），显著低于SII、LMR和LMR/LDH低的患者（P<0.05）；SII、LMR和LMR/LDH呈正相关（P<0.05）。Cox比例风险回归分析显示，SII、LMR和LMR/LDH是DLBCL患者预后的影响因素（风险比分别为1.143、1.665和1.704；P<0.05）。
SII、LMR和LMR/LDH与DLCBL的临床病理特征相关，也影响该疾病患者的预后。
