OBJECTIVE: To establish a model to predict the overall survival (OS) rate of patients with diffuse large B-cell lymphoma (DLBCL) based on systemic inflammatory indicators, and study whether the new model combined with inflammatory related parameters is more effective than the conventional model using only clinical factors to predict the OS of patients with DLBCL.
METHODS: The clinical data of 213 patients with DLBCL were analyzed retrospectively. Backward stepwise Cox regression analysis was used to screen independent prognostic factors related to OS, and a nomogram for predicting OS was constructed based on these factors. Akaike information criterion (AIC) and Bayesian information criterion (BIC) were used to evaluate the fitting of the model, the consistency index (C-index), area under receiver operating characteristic (ROC) curve (AUC) and calibration curve were used to evaluate the prediction accuracy of nomogram, and decision curve analysis (DCA) and Kaplan Meier curve were used to evaluate the clinical practicability of nomogram.
RESULTS: Multivariate analysis confirmed that age, ECOG PS score, serum lactate dehydrogenase (LDH) level, systemic immune inflammatory index (SII), and prognostic nutritional index (PNI) were used to construct the nomogram. The AIC and BIC of the nomogram were lower than the International Prognostic Index (IPI) and the National Comprehensive Cancer Network (NCCN)-IPI, indicating that the nomogram had better goodness of fit. The C-index and AUC of the nomogram were higher than IPI and NCCN-IPI, indicating that the prediction accuracy of the nomogram had been significantly improved, and the calibration curve showed that the prediction results were in good agreement with the actual survival results. DCA showed that the nomogram had better clinical net income. Kaplan Meier curve showed that patients could be well divided into low-risk, medium-risk and high-risk groups according to the nomogram score (P < 0.001).
CONCLUSIONS: The nomogram combined with inflammatory indicators can accurately predict the individual survival probability of DLBCL patients.
UNASSIGNED: 系统性炎症指标可以改善弥漫大B细胞淋巴瘤患者的生存预测:模型的开发和评价.
UNASSIGNED: 基于全身炎症指标建立一个用于预测弥漫大B细胞淋巴瘤(DLBCL)患者总生存(OS)率的模型,并研究结合炎症相关参数的新模型是否比仅使用临床因素的常规模型能更有效地预测DLBCL患者的OS。.
UNASSIGNED: 回顾性分析了213例DLBCL患者的临床数据,向后逐步Cox回归分析筛选与OS相关的独立预后因素,基于这些因素构建预测OS的列线图。使用Akaike信息准则(AIC)和Bayesian信息准则(BIC)评估模型的拟合情况,一致性指数、受试者工作特征曲线下面积(AUC)和校准曲线评估列线图的预测准确性,使用决策曲线分析和Kaplan-Meier曲线评估列线图的临床实用性。.
UNASSIGNED: 多变量分析确定年龄、美国东部合作组体能状态评分、血清乳酸脱氢酶水平、全身免疫炎症指数、预后营养指数用于构建列线图。列线图的AIC和BIC低于国际预后指数(IPI)和美国国家综合癌症网络(NCCN)-IPI,表明列线图具有更好的拟合优度。列线图的一致性指数和AUC高于IPI和NCCN-IPI,表明列线图的预测准确性明显改善,校准曲线显示出预测结果和实际生存结果具有良好的一致性。决策曲线分析显示列线图具有更好的临床净收益。Kaplan-Meier曲线显示,根据列线图评分可以很好地将患者分为低危、中危、高危三个风险组(P < 0.001)。.
UNASSIGNED: 结合炎症指标的列线图可以准确地预测DLBCL患者个体化的生存概率。.