The prognostic value of neutrophil/lymphocyte ratio and systemic immunoinflammatory index in PGI-DLBCL
Objective To investigate the relationship between peripheral neutrophil/lymphocyte ratio(NLR),systemic immunoinflammatory index(SII)and prognosis in patients with primary gastrointestinal diffuse large B-cell lymphoma(PGI-DLBCL)before chemotherapy.Methods A total of 93 PGI-DLBCL patients attending the Affiliated Hospital of Xuzhou Medical University from January 2010 to February 2021 were selected as the study subjects.Clinical data of patients diagnosed with PGI-DLBCL were reviewed and analyzed.The truncation values of NLR and SII were determined according to receiver operating characteristic(ROC),and then divided into high and low group,respectively.The prognosis and survival of the two groups were analyzed and summarized.Survival analysis was performed by Kaplan-Meier test and Log-rank test,and risk factors were analyzed by Cox proportional hazard regression model.Results According to ROC curve,the cut-off value of NLR was 3.974 and that of SII was 853.775.According to the cut-off value,31 patients were classified in the high NLR group,62 in the low NLR group,40 in the high SII group and 53 in the low SII group.Univariate analysis of Cox regression model showed that ANC>4.620,MLR>0.254,NLR>3.974 and SII>853.775 were all risk factors affecting 5-year PFS of patients(all P<0.05).Multivariate analysis indicated that NLR>3.974 and SII>853.775 were independent risk factors affecting the prognosis of patients(all P<0.05).Analysis of clinical features between groups suggested that the high NLR group and the high SII group tended to be distributed in patients with late clinical stage(c2=7.971,6.996,P=0.004,0.008)and high international prognostic(IPI)score(c2=13.527,8.877,P<0.001,0.003).Survival analysis indicated that patients in the low NLR group had longer median progress free survival(PFS)and median overall survival(OS)than those in the high NLR group,and patients in the low SII group had longer median PFS and median OS than those in the high SII group,all the differences were statistically significant(all P<0.05).Conclusions NLR and SII were independent prognostic risk factors for PGI-DLBCL patients at initial diagnosis.The higher the NLR and SII,the worse was the prognosis.
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