背景:目前,外周血标志物是结外鼻型自然杀伤/T细胞淋巴瘤(ENKTCL)的信息和有临床价值的预后指标.然而,其综合评分在ENKTCL中的作用尚待确定。
目标:因此,本研究旨在探讨外周炎症评分对ENKTCL预后的影响。
方法:回顾性研究纳入183例ENKTCL患者。使用单变量Cox回归分析和最小绝对收缩和选择算子(LASSO)Cox回归构建炎症相关的预后指标Risk。使用单因素和多因素Cox回归分析以及倾向评分匹配(PSM)回归校正来评估风险的预后能力。通过整合风险来评估修改的列线图修订的风险指数(NRI)的性能与时间依赖性受试者工作特征(ROC)曲线(AUC)下的面积,决策曲线分析(DCA),和综合Brier评分(IBS)。
结果:风险截止值,由淋巴细胞计数构成,血小板计数,白蛋白水平,LMR,PNI,为-1.3486。在PSM之前,多因素分析显示,风险与OS(HR=2.577,95%CI=1.614~4.114,P<0.001)和PFS(HR=2.679,95%CI=1.744~4.114,P<0.001)显著相关。PSM调整后,风险仍然是OS(HR=2.829,95%CI=1.601-5.001,P<0.001)和PFS(HR=2.877,95%CI=1.735-4.770,P<0.001)的独立因素.有了NRI,通过整合风险的改良NRI增加了AUC和临床净获益,降低了Brier积分.
结论:风险是一种易于获得且廉价的指标,可用作预后指标,并可提高ENKTCL患者的NRI预测能力。
BACKGROUND: At present, peripheral blood markers are easily accessible information and clinically valuable prognostic indicators in extranodal nasal-type natural killer/T-cell lymphoma (ENKTCL). Nevertheless, the role of its comprehensive score in ENKTCL remains to be determined.
OBJECTIVE: Therefore, this study aimed to investigate the prognostic effect of the peripheral inflammation score on ENKTCL.
METHODS: The retrospective study included 183 patients with ENKTCL. Univariate Cox regression analyses and least absolute shrinkage and selection operator (LASSO) Cox regression were used to construct the inflammation-related prognostic index named Risk. Univariate and multivariate Cox regression analyses and regression adjustment with propensity score matching (PSM) were used to evaluate the prognostic ability of risk. The performance of the modified nomogram-revised risk index (NRI) by integrating risk was evaluated with the area under the time-dependent receiver operating characteristic (ROC) curve (AUC), decision curve analysis (DCA), and integrated Brier score (IBS).
RESULTS: The risk cut-off value, constructed by the lymphocyte count, platelet count, albumin level, LMR, and PNI, was -1.3486. Before PSM, multivariate analysis showed that risk was significantly associated with OS (HR = 2.577, 95% CI = 1.614-4.114, P< 0.001) and PFS (HR = 2.679, 95% CI = 1.744-4.114, P< 0.001). After PSM adjustment, risk was still an independent factor for OS (HR = 2.829, 95% CI = 1.601-5.001, P< 0.001) and PFS (HR = 2.877, 95% CI = 1.735-4.770, P< 0.001). With the NRI, the modified NRI by integrating risk increased the AUC and clinical net benefit and decreased the IBS.
CONCLUSIONS: Risk is an easily accessible and inexpensive indicator that may be used as a prognostic marker and could improve NRI predictive power in patients with ENKTCL.