外周血血小板与淋巴细胞的比值及淋巴细胞与单核细胞的比值与老年眼眶弥漫性大B细胞淋巴瘤的相关性

Correlation of platelet to lymphocyte ratio and lymphocyte to monocyte ratio in peripheral blood in elderly patients with orbital diffuse large B-cell lymphoma

目的探讨外周血常规检测各项指标及比值与眼眶弥漫性大B细胞淋巴瘤(diffuse large B-cell lymphoma,DLBCL)的相关性。方法本研究为病例对照研究,收集2015年1月-2022年12月于复旦大学附属肿瘤医院确诊为眼眶DLBCL老年患者作为疾病组(眼眶DLBCL组),原发性中枢神经系统DLBCL患者作为疾病对照组(PCNSL-DLBCL组),以及健康人群作为健康对照组。使用方差分析比较3组间血常规检测的各项参数的差异。Lasso回归筛选出眼眶DLBCL的关键因素,并通过Logistic回归确认。绘制ROC曲线,计算线下面积。结果3组之间年龄与性别相匹配(P>0.05)。相较于健康对照组,眼眶DLBCL组的单核细胞计数(M)、血小板与淋巴细胞的比值(PLR)、中性粒细胞与淋巴细胞的比值(NLR)、系统性免疫炎症指数(SII)、红细胞分布宽度(RDW)、乳酸脱氢酶(LDH)显著升高,而淋巴细胞计数(L)、淋巴细胞与单核细胞比值(LMR)显著降低,差异均具有统计学意义(P<0.05)。Lasso回归分析显示,PLR和LMR是眼眶DLBCL病变的重要影响因素。进一步Logistic回归分析发现,L降低(OR,11.1868;95%CI,4.222229.6401;P<0.0001)、M升高(OR,1.8990;95%CI,1.488929.6401;P<0.0001)、PLR升高(OR,1.0609;95%CI,1.02251.1009;P=0.0017)和NLR升高(OR,4.5157;95%CI,2.71277.5170;P<0.0001)是眼眶DLBCL的独立危险因素,而LMR升高是DLBCL的保护因素(OR,0.3923;95%CI,0.22970.6698;P=0.006)。ROC曲线分析发现,PLR与LMR联合运用对眼眶DLBCL具有一定的诊断价值(AUC=0.877)。结论外周血PLR和LMR与眼眶DLBCL相关。PLR升高和LMR减低可能是眼眶DLBCL病变的危险因素,为疾病探索新的生物标志物提供初步临床检验学证据。

Objective To investigate the correlation between various indicators and ratios of peripheral blood routine tests and orbital diffuse large B-cell lymphoma(DLBCL).Methods This was a case-control study.Elderly patients diagnosed with orbital DLBCL in Fudan University Shanghai Cancer Center from January 2015 to December 2022 were selected as the disease group(orbital DLBCL group),primary central nervous system DLBCL patients as the disease control group(PCNSL-DLBCL group),and healthy people as the healthy control group.Chi-Square analysis was used to compare the differences in the parameters of blood routine tests among the three groups.The key factors of orbital DLBCL were screened by Lasso regression and confirmed by logistic regression.The receiver-operator characteristic(ROC)curve was plotted and the area under the curve was calculated.Results Age and gender were matched among the three groups(P>0.05).Compared with the healthy control group,the levels of monocyte count(M),platelet to lymphocyte ratio(PLR),neutrophil to lymphocyte ratio(NLR),systemic immunoinflammatory index(SII),red blood cell distribution width(RDW)and lactate dehydrogenase(LDH)increased significantly in the orbital DLBCL group,and the levels of lymphocyte count(L)and lymphocyte to monocyte ratio(LMR)decreased significantly,with statistical significance(P<0.05).Lasso regression analysis showed that PLR and LMR were important influencing factors for orbital DLBCL lesions.Logistic regression analysis found that decreased L(OR,11.1868;95%CI,4.2222-29.6401;P<0.0001),elevated M(OR,1.8990;95%CI,1.4889-29.6401;P<0.0001),elevated PLR(OR,1.0609;95%CI,1.0225-1.1009;P=0.0017)and elevated NLR(OR,4.5157;95%CI,2.7127-7.5170;P<0.0001)was independent risk factors for orbital DLBCL,while elevated LMR was a protective factor for DLBCL(OR,0.3923;95%CI,0.2297-0.6698;P=0.006).ROC curve analysis revealed that the combination of PLR and LMR has certain diagnostic value for orbital DLBCL(AUC=0.877).Conclusion PLR and LMR in peripheral blood are correlated with orbital DLBCL.Elevated PLR and decreased LMR may be valuable risk factors for orbital DLBCL,which provide preliminary clinical laboratory evidence for exploring new biomarkers of the disease.