晚期肺癌炎症指数、预后营养指数对弥漫性大B细胞淋巴瘤预后预测价值

Prognostic Value of Inflammatory Index and Prognostic Nutrient Index for Advanced Lung Cancer in Patients with Diffuse Large B-Cell Lymphoma

目的:探讨晚期肺癌炎症指数(ALI)、预后营养指数(PNI)对弥漫性大B细胞淋巴瘤(DLBCL)预后的预测价值。方法:收集2017年5月—2018年5月我院收治的DLBCL患者114例,根据患者预后情况分为复发组(61例)与非复发组(53例),比较两组临床资料,采用Logistic回归分析影响复发的因素;采用ROC曲线分析ALI、PNI预测患者预后的效能。结果:复发组组织学分型为非生发中心型、Ann Arbor分期为Ⅲ~Ⅳ期、Ki67阳性率>70%患者比例以及中性粒细胞计数高于非复发组,白蛋白、淋巴细胞计数、ALI指数、PNI指数低于非复发组(P<0.05);Logistic回归分析显示,ALI降低(OR=2.321)、PNI降低(OR=1.832)、AnnArbor分期为Ⅲ~Ⅳ期(OR=2.094)、组织学分型为非生发中心型(OR=1.957)是影响DLBCL患者复发的独立危险因素(P<0.05);ROC分析显示,ALI、PNI预测DLBCL复发的AUC值分别为0.757、0.628(P<0.05)。结论:ALI、PNI对DLBCL治疗预后具有预测价值,有望为患者危险分层提供参考依据。

Objective:To explore the predictive value of advanced lung cancer inflammation index(ALI) and prognostic nutritional index(PNI) on the prognosis of diffuse large B-cell lymphoma(DLBCL).Methods:114 DLBCL patients admitted to our hospital from May 2017 to May 2018 were collected and divided into relapse group(61 cases) and non-recurrence group(53 cases) according to their prognosis.The clinical data of the two groups were compared,and the factors affecting relapse were analyzed by Logistic regression.ROC curve was used to analyze the prognostic efficacy of ALI and PNI.Results:The histological type of recurrent group was non-germinal central type,the Ann Arbor stage was Ⅲ to Ⅳ,the proportion of patients with Ki67 positive rate > 70% and neutrophil count were higher than those of non-recurrent group,while the albumin,lymphocyte count,ALI index and PNI index were lower than those of non-recurrent group(P<0.05).Logistic regression analysis showed that decreased ALI(OR=2.321),decreased PNI(OR=1.832),Ann Arbor stage Ⅲ to Ⅳ(OR=2.094) and non-germinal center type(OR=1.957) were independent risk factors for recurrence in DLBCL patients(P<0.05).ROC analysis showed that the AUC values of ALI and PNI for predicting DLBCL recurrence were 0.757 and 0.628,respectively(P< 0.05).Conclusion:ALI and PNI have predictive value for the prognosis of DLBCL treatment,and are expected to provide reference for risk stratification of patients.