全身免疫炎症指数对弥漫大B细胞淋巴瘤老年患者预后的评估价值

Evaluation value of systemic immune-inflammation index in evaluating the prognosis of elderly patients with diffuse large B-cell lymphoma

目的探讨全身免疫炎症指数(SⅡ)对弥漫大B细胞淋巴瘤(DLBCL)老年患者预后的评估价值。方法选取DLBCL老年患者91例作为研究对象,收集所有患者年龄、性别、是否吸烟、临床分期、美国东部肿瘤协作组(ECOG)评分、国际预后指数(IPI)、结外累及个数等资料;抽取患者空腹血,采用库尔特原理检测血清血小板计数(PLT)、中性粒细胞(NEA)及淋巴细胞(LYM)数,并根据PLT、NEA及LYM计算SⅡ,采用免疫法检测乳酸脱氢酶(LDH)、用免疫比浊法检测β2-微球蛋白(β2-MG)水平;采用ROC曲线分析患者SⅡ的截断值,据此截断值将患者分为高SⅡ组和低SⅡ组,采用单因素及多因素分析2组患者临床特征的差异;随访2组患者的生存情况,计算3年总生存(OS)率及无进展生存(PFS)率;采用R-studio构建以SⅡ为主的DLBCL老年患者预后预测模型。结果ROC曲线结果显示SⅡ临界值为582.6,DLBCL老年患者分为高SⅡ组(SⅡ≥582.6,n=57)和低SⅡ组(SⅡ<582.6,n=34),2组患者ROC的曲线下面积(AUC)为0.651,95%CI为0.535~0.766(P=0.015);生存曲线显示,低SⅡ组DLBCL老年患者OS及PFS均高于高SⅡ组;高SⅡ是影响DLBCL老年患者OS及PFS的独立预后因素(P<0.05);DLBCL老年患者以SⅡ为主的预后预测模型具有统计学意义(P<0.05)。结论SⅡ水平与DLBCL老年患者的预后相关,高SⅡ组患者预后较差。

Objective To investigate the value of systemic immune-inflammation index(SII)in evaluating the prognosis of elderly patients with diffuse large B-cell lymphoma(DLBCL).Methods Ninety-one elderly patients(≥60 years old)diagnosed with DLBCL were selected as study subjects.Relevant information was collected,including age,gender,smoking status,clinical stage,American Eastern Cooperative Oncology Group(ECOG)score,international prognostic index(IPI)and the number of extra-nodal involvement were collected.Fasting blood samples were obtained from the patients to measure serum platelet count(PLT),neutrophil(NE)count,and lymphocyte(LYM)count using Coulter principle.SII was calculated based on PLT,NE,and LYM values.Lactate dehydrogenase(LDH)level was measured using immunological assays,whileβ2-microglobulin(β2-MG)level was determined using immunoturbidimetry assay.The optimal cutoff value for SII was determined using receiver operating characteristic(ROC)curve analysis,used for stratifying the patients into high-and low-SII groups.Differences in clinical characteristics between two groups were analyzed using both univariate and multivariate approaches.Two groups of patients were followed up for their survival status.The 3-year overall survival(OS)rate and progression-free survival(PFS)rate were calculated.R-studio was applied to construct a prognosis prediction model for elderly DLBCL patients with SII as the main focus.Results ROC curve results showed that the critical value of SII was 582.6.The elderly patients with DLBCL were divided into a high-SII group(SII≥582.6,n=57)and a low-SII group(SII<582.6,n=34).The area under the curve(AUC)of the ROC in both groups was 0.651,with a 95%CI of 0.535-0.766(P=0.015).Survival curves shows that OS and PFS of elderly patients with DLBCL in low-SII group were higher than those in high-SII group.High SII was an independent prognostic factor affecting OS and PFS of elderly patients with DLBCL(P<0.05).The prognosis prediction model based on SII in elderly patients with DLBCL was statistically significant(P<0.05).Conclusion SII level is correlated with the prognosis of the elderly patients with DLBCL,and the prognosis of high-SII group is worse.