KPI与IPI预后模型对R-CHOP治疗DLBCL预后评价效力的比较

Comparison of KPI and IPI in evaluating the prognosis of DLBCL treated with R-CHOP

目的验证在利妥昔单抗时代京都预后指数(KPI)是否能比国际预后指数(IPI)更能有效识别弥漫大B细胞淋巴瘤(DLBCL)高危患者并评估预后。方法回顾性分析2012年6月-2020年9月兰州大学第一医院收治的73例初治DLBCL患者的临床资料,按KPI及IPI重新对患者风险分层,采用Kaplan-Meier法分析2组患者的无进展生存期和总生存期,利用桑葚图比较IPI及KPI对DLBCL患者的预后准确性,Harrell's C统计比较各模型的预后分层能力。结果2年生存分析结果提示IPI及KPI均具有预后分层能力(P<0.05),KPI高危患者生存劣于IPI高危患者(2年总生存期分别为33.3%、55.6%)。结论在利妥昔单抗时代,KPI相比IPI能更好地识别高危DLBCL患者。

Objective The Kyoto prognostic index(KPI)and international prognostic index(IPI)were compared to verify whether KPI can be more effective than IPI in identifying and assessing the prognosis of highrisk patients with diffuse large B cell lymphoma(DLBCL)in the era of rituximab.Methods The clinical data of 73 patients with DLBCL admitted to The First Hospital of Lanzhou University from June 2012 to September 2020 were analyzed retrospectively.KPI and IPI re-stratified these patients according to the data at initial diagnosis.The Kaplan-Meier method was used to analyze the progression free survival and overall survival of the stratified groups with the two models.The Sankey diagram was used to compare the prognostic accuracy by IPI and KPI.And Harrell's C statistics were used to compare the prognostic stratification ability of two prognostic models.Results The results of a 2-year survival analysis showed that both IPI and KPI showed prognostic stratification ability in rituximab era(P<0.05),and patients with a high-risk KPI index showed worse survival benefit than that with high-risk IPI index(the 2-year overall survival was 33.3%and 55.6%,respectively).Conclusion In the era of rituximab,KPI can identify high-risk DLBCL patients more accurately than IPI.