Lian Ke, Zhu Wenyao, Hu Zhihui, Su Fang, Xu CaiXia, Wang Hui
Department Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China.
Department of Radiotherapy, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, China.
Front Immunol. 2025 Aug 6;16:1539924. doi: 10.3389/fimmu.2025.1539924. eCollection 2025.
The objective of this study is to evaluate the incidence, prognostic value, and risk factors of progression of disease within 12 months (POD12) in patients with diffuse large B-cell lymphoma (DLBCL).
A retrospective analysis of the clinical, pathological, and follow-up data was carried out on 69 DLBCL cases in Shanxi Bethune Hospital from January 2016 to June 2020. One-way ANOVA and multivariate Cox regression analysis were used to explore the correlation between POD12 and prognosis, and logistic regression analysis was used to explore the risk factors of POD12, accompanied by prediction models based on convolutional neural networks and long short-term memory (CNN-LSTM), as well as particle swarm optimization and general regression neural network (PSO-GRNN) models.
(1) POD12 is significantly correlated with PFS ( 0.001) and OS ( = 0.008). (2) From the univariate logistic regression analysis corrected by the first-line chemotherapy regimen, LDH, β-MG, stage, ECOG, NLR, and SII are identified as risk factors for POD12 ( 0.1), while β-MG and ECOG are identified as independent risk factors from the multivariate logistic regression analysis (< 0.05). (3) A prediction model for POD12 is established based on LDH, β-MG, stage, ECOG, NLR, and SII. The AUC is 0.846 (95% CI: 0.749~0.944, 0.001), suggesting that the model is reasonable. A prediction method for the characteristic variables of POD12 risk is proposed using the CNN-LSTM deep learning model based on chaotic time series. Comparatively, the CNN-LSTM and PSO-GRNN models are the most suitable to predict the risk level of the POD12 in the future.
本研究旨在评估弥漫性大B细胞淋巴瘤(DLBCL)患者12个月内疾病进展(POD12)的发生率、预后价值及危险因素。
对山西白求恩医院2016年1月至2020年6月期间的69例DLBCL病例的临床、病理及随访数据进行回顾性分析。采用单因素方差分析和多因素Cox回归分析探讨POD12与预后的相关性,采用逻辑回归分析探讨POD12的危险因素,并构建基于卷积神经网络和长短期记忆网络(CNN-LSTM)以及粒子群优化和广义回归神经网络(PSO-GRNN)的预测模型。
(1)POD12与无进展生存期(PFS,P = 0.001)和总生存期(OS,P = 0.008)显著相关。(2)经一线化疗方案校正的单因素逻辑回归分析显示,乳酸脱氢酶(LDH)、β2微球蛋白(β-MG)、分期、美国东部肿瘤协作组(ECOG)体能状态评分、中性粒细胞与淋巴细胞比值(NLR)和全身炎症反应指数(SII)是POD12的危险因素(P < 0.1);多因素逻辑回归分析显示,β-MG和ECOG是独立危险因素(P < 0.05)。(3)基于LDH、β-MG、分期、ECOG、NLR和SII建立了POD12预测模型,曲线下面积(AUC)为0.846(95%可信区间:0.749~0.944,P = 0.001),提示该模型合理。基于混沌时间序列的CNN-LSTM深度学习模型提出了一种POD12风险特征变量的预测方法。比较而言,CNN-LSTM和PSO-GRNN模型最适合预测未来POD12的风险水平。