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Abstract：
With the continuous improvement of treatment strategy, the prognostic value of international prognostic index (IPI) alone is limited for diffuse large B-cell lymphoma (DLBCL). Our study aims to explore the effect of lactate dehydrogenase (LDH)to absolute lymphocyte count (ALC) ratio (LAR) and albumin to fibrinogen ratio (AFR) on the prognosis of patients with DLBCL. The venous blood LDH, ALC, albumin and fibrinogen within 1 week before the first chemotherapy in 74 DLBCL patients were collected to calculate the LAR and AFR values. The impact of LAR and AFR on the progression-free survival (PFS) of patients with DLBCL was studied by the survival analysis. The area under the receiver operating characteristic curve (AUC) and concordance index (C-index) were used to analyze the predictive efficiency of each model for the PFS of DLBCL patients. Cox univariate analysis suggested that elevated LAR (P < .001) and decreased AFR (P < .001) were risk factors for PFS in DLBCL patients. Multivariate analysis revealed that LAR (P < .001) and AFR (P = .004) were 2 independent prognostic parameters. The AUC values of IPI, AFR + IPI, LAR + IPI and AFR + LAR + IPI to predict the PFS of DLBCL patients were 0.806 (95%CI 0.707-0.905, P < .001), 0.839 (95%CI 0.747-0.932, P < .001), 0.851 (95%CI 0.764-0.938, P < .001), and 0.869 (95%CI 0.787-0.952, P < .001), respectively. The C-index values of above 4 models were 0.802 (95%CI 0.629-0.975, P < .001), 0.842 (95% CI 0.735-0.949, P < .001), 0.846 (95%CI 0.716-0.976, P < .001), and 0.864 (95%CI 0.781-0.941, P < .001), respectively. The results suggest that both LAR and AFR are independent prognostic factors for PFS in DLBCL patients. Furthermore, their combination with IPI has better predictive efficiency for the prognosis of DLBCL patients.
摘要：
随着治疗策略的不断完善,国际预后指数(IPI)对弥漫性大B细胞淋巴瘤(DLBCL)的预后价值有限.本研究旨在探讨乳酸脱氢酶(LDH)与淋巴细胞绝对计数(ALC)比值(LAR)和白蛋白与纤维蛋白原比值(AFR)对DLBCL患者预后的影响。静脉血LDH,ALC,收集74例DLBCL患者首次化疗前1周内的白蛋白和纤维蛋白原，计算LAR和AFR值。通过生存分析研究了LAR和AFR对DLBCL患者无进展生存（PFS）的影响。采用受试者工作特征曲线下面积(AUC)和一致性指数(C指数)分析各模型对DLBCL患者PFS的预测效率。Cox单因素分析显示，LAR升高（P<.001）和AFR降低（P<.001）是DLBCL患者PFS的危险因素。多因素分析显示LAR(P<.001)和AFR(P=.004)是2个独立的预后参数。IPI的AUC值，AFR+IPI,LAR+IPI和AFR+LAR+IPI预测DLBCL患者PFS为0.806(95CI0.707-0.905,P<.001),0.839（95CI0.747-0.932，P<.001），0.851（95CI0.764-0.938，P<.001），和0.869（95CI0.787-0.952，P<.001），分别。上述4种模型的C指数值为0.802(95CI0.629-0.975,P<.001),0.842（95%CI0.735-0.949，P<.001），0.846（95CI0.716-0.976，P<.001），和0.864（95CI0.781-0.941，P<.001），分别。结果表明，LAR和AFR是DLBCL患者PFS的独立预后因素。此外，两者联合IPI对DLBCL患者的预后具有更好的预测效能.
