Objective: To explore the effects of prognostic nutritional index (PNI) combined with D-dimer on the prognosis of patients with newly diagnosed diffuse large B-cell lymphoma (DLBCL).
Methods: The clinical data of 73 DLBCL patients at initial diagnosis were retrospectively evaluated, and the optimal cut-off point of PNI and D-dimer were determined by ROC curve. The overall survival (OS) rate and progression-free survival (PFS) rate in different subgroups were compared using Kaplan-Meier survival curves. Univariate and multivariate Cox regression analysis was performed to identify the factors associated with OS.
Results: Compared with the low PNI group (PNI<44.775), the high PNI group (PNI≥44.775) had better OS (P =0.022) and PFS (P =0.029), the 2-year OS rates of the two groups were 55.6% and 78.3% respectively (P =0.041). Compared with the high D-dimer group (D-dimer≥0.835), the low D-dimer group (D-dimer<0.835) had better OS (P <0.001) and PFS (P <0.001), the 2-year OS rates of the two groups were 51.4% and 86.8% respectively (P =0.001). Meanwhile, patients in the high PNI+ low D-dimer group had better OS (P =0.003) and PFS (P <0.001) than the other three groups, the 2-year OS rate was statistically different from the other three groups (P <0.05). The multivariate analysis revealed that NCCN-IPI (HR =2.083, 95%CI : 1.034-4.196, P =0.040), PNI (HR =0.267, 95%CI : 0.076-0.940, P =0.040) and PNI+D-dimer (HR =9.082, 95%CI : 1.329-62.079, P =0.024) were the independent risk factors affecting OS in patients with DLBCL. Subgroup analysis showed that PNI, D-dimer, and PNI combined with D-dimer could improve the prognostic stratification in low and low-intermediate risk DLBCL patients.
Conclusion: High PNI, low D-dimer and combination of high PNI and low D-dimer at initial diagnosis suggest a better prognosis in DLBCL patients.
题目: 预后营养指数联合D-二聚体对弥漫大B细胞淋巴瘤患者预后的评估价值.
目的: 探究预后营养指数（PNI）联合D-二聚体（D-dimer）对初诊弥漫大B细胞淋巴瘤（DLBCL）患者预后的影响。.
方法: 回顾性分析73例DLBCL患者初诊时的临床资料，通过ROC曲线确定PNI和D-dimer的最佳截断值；采用Kaplan-Meier生存曲线比较不同分组患者的总生存（OS）率和无进展生存（PFS）率；采用Cox回归模型进行单变量和多变量分析，确定与OS相关的因素。.
结果: 与低PNI组（PNI<44.775）相比，高PNI组（PNI≥44.775）有更好的OS（P =0.022）和PFS（P =0.029），两组2年OS率分别为55.6%和78.3%（P =0.041）；与高D-dimer组（D-dimer≥0.835）相比，低D-dimer组（D-dimer<0.835）具有更好的OS（P <0.001）和PFS（P <0.001），两组2年OS率分别为51.4%和 86.8%（P =0.001）；同时，高PNI+低D-dimer组患者较其他3组具有更好的OS（P =0.003）和PFS（P <0.001），2年OS 率具有统计学差异（P <0.05）。多因素分析结果显示，NCCN-IPI（HR =2.083，95% CI ：1.034-4.196，P =0.040）、PNI（HR = 0.267，95% CI ：0.076-0.940，P =0.040）、PNI+D-dimer（HR =9.082，95% CI ：1.329-62.079，P =0.024）是影响DLBCL患 者OS的独立危险因素。亚组分析结果发现，PNI、D-dimer、PNI联合D-dimer能够改善低危、低中危DLBCL患者的预 后分层。.
结论: 初诊时高PNI、低D-dimer及高PNI+低D-dimer的DLBCL患者具有更好的预后。.
Keywords: D-dimer; diffuse large B-cell lymphoma; prognosis; prognostic nutritional index.