Glasgow prognostic score is superior to other inflammation-based scores in predicting survival of diffuse large B-cell lymphoma.
Glasgow prognostic score is superior to other inflammation-based scores in predicting survival of diffuse large B-cell lymphoma.
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格拉斯哥预后评分在预测弥漫性大 B 细胞淋巴瘤的生存方面优于其他基于炎症的评分
DOI：
10.18632/oncotarget.20832
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发表时间：
2017-09-29
期刊：
影响因子：
--
通讯作者：
Feng R
中科院分区：
文献类型：
--
作者：
Hao X;Wei Y;Wei X;Zhou L;Wei Q;Zhang Y;Huang W;Feng R
以炎症为基础的预后评分，如格拉斯哥预后评分(GPS)、预后指数(PI)、预后营养指数(PNI)、中性粒细胞淋巴细胞比率(NLR)和血小板淋巴细胞比率(PLR)与许多实体瘤的生存有关。最近的研究表明，GPS可以用来预测弥漫性大B细胞淋巴瘤(DLBCL)的预后。然而，其他与炎症相关的评分还没有报道，也不清楚哪种评分对评估DLBCL的生存最有用。在这项回顾性研究中，纳入了2003年1月至2014年12月期间新诊断并经组织学证实的252例DLBCL。单因素分析显示，高GPS、高PI、高NLR、高PLR和低PNI均与总体生存率(p<；0.05)和无事件生存率(p<；0.05)相关。多因素分析显示，GPS(HR=1.781，95%CI=1.065~2.979，P=0.028)仍是DLBCL的独立预后因素。C指数(0.735，95%CI=0.645~0.824)大于PI(0.710，95%CI=0.621~0.799，P=0.602)、PNI(0.600，95%CI=0.517~0.683，P=0.001)、PLR(0.599，95%CI=0.510~0.689，P=0.029)和NLR(0.572，95%CI=0.503~0.642，P=0.05)。P=0.005)。特别是在接受R-CHOP治疗的DLBCL中，与其他预后评分相比，GPS仍然是最有力的预后评分(OS和EFS分别为p=0.001和p<；0.001)。提示以炎症为基础的预后评分，如GPS、PI、NLR、PNI和PLR均可用于预测DLBCL的预后。其中，GPS是预测DLBCL患者生存的最有力的指标，即使在利妥昔单抗时代也是如此。
Inflammation-based prognostic scores, such as the glasgow prognostic score (GPS), prognostic index (PI), prognostic nutritional index (PNI), neutrophil lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR) were related to survival in many solid tumors. Recent study showed that GPS can be used to predict outcome in diffuse large B-cell lymphoma (DLBCL). However, other inflammation related scores had not been reported and it also remained unknown which of them was the most useful to evaluate the survival in DLBCLs. In this retrospective study, a number of 252 newly diagnosed and histologically proven DLBCLs from January 2003 to December 2014 were included. The high GPS, high PI, high NLR, high PLR and low PNI were all associated with poor overall survival (p < 0.05) and event-free survival (p < 0.05) in univariate analysis. Multivariate analysis indicated that GPS (HR = 1.781, 95% CI = 1.065–2.979, p = 0.028) remained an independent prognostic predictor in DLBCL. The c-index of GPS (0.735, 95% CI = 0.645–0.824) was greater than that of PI (0.710, 95% CI = 0.621–0.799, p = 0.602), PNI (0.600, 95% CI = 0.517–0.683, p = 0.001), PLR (0.599, 95% CI = 0.510–0.689, p = 0.029) and NLR (0.572, 95% CI = 0.503–0.642, p = 0.005) by Harrell's concordance index. Especially in DLBCLs treated with R-CHOP, GPS still remained the most powerful prognostic score when comparing with others (p = 0.001 and p < 0.001, respectively for OS and EFS). In conclusion, it is indicated that inflammation-based prognostic scores such as GPS, PI, NLR, PNI and PLR all could be used to predict the outcome of DLBCLs. Among them, GPS is the most powerful indicator in predicting survival in DLBCLs, even in the rituximab era.