EASIX在弥漫大B细胞淋巴瘤中的预后价值评估:一项淮海淋巴瘤协作组的多中心回顾性研究  

Assessment of the prognostic value of EASIX in diffuse large B-cell lymphoma:A multicenter retrospective study of Huaihai Lymphoma Working Group

作　　者：李大珊 邓玲 葛洪峰[2] 朱俊峰[3] 王玲[4] 史玉叶[5] 张颢[6] 沈子园 桑威 淮海淋巴瘤协作组 LI Dashan;DENG Ling;GE Hongfeng;ZHU Junfeng;WANG Ling;SHI Yuye;ZHNAG Hao;SHEN Ziyuan;SANG Wei;Huaihai Lymphoma Working Group(Department of Hematology,the Affiliated Hospital of Xuzhou Medical University,Xuzhou,Jiangsu 221002,China;Department of Hematology,Bozhou People′s Hospital,Bozhou,Anhui 236800;Department of Hematology,the First Affiliated Hospital of Bengbu Medical College,Bengbu,Anhui 233004;Department of Hematology,Tai′an Central Hospital,Tai′an,Shandong 271000;Department of Hematology,the First People′s Hospital of Huai′an,Huai′an,Jiangsu 223000;Department of Hematology,the Affiliated Hospital of Jining Medical University,Jining,Shandong 272000;Department of Epidemiology and Biostatistics,School of Public Health,Anhui Medical University,Hefei,Anhui 230032;不详)

机构地区：[1]徐州医科大学附属医院血液科,江苏徐州221002 [2]亳州市人民医院血液科,安徽亳州236800 [3]蚌埠医学院第一附属医院血液科,安徽蚌埠233004 [4]泰安市中心医院血液科,山东泰安271000 [5]淮安市第一人民医院血液科,江苏淮安223000 [6]济宁医学院附属医院血液科,山东济宁272000 [7]安徽医科大学公共卫生学院,安徽合肥230032 [8]不详

出　　处：《徐州医科大学学报》2024年第1期47-54,共8页Journal of Xuzhou Medical University

基　　金：江苏省自然科学基金(BK20171181);江苏省科技厅社会发展重点项目(BE2019638);江苏省青年医学重点人才项目(QNRC2016791)。

摘　　要：目的探讨内皮活化和应激指数(EASIX)对初诊弥漫大B细胞淋巴瘤(DLBCL)患者预后的价值。方法选取2008年8月—2022年3月在淮海淋巴瘤协作组中6家医疗中心诊断为DLBCL的580例患者,收集临床资料进行回顾性分析。基于MaxStat统计量确定EASIX的最佳截断值。使用Cox比例风险模型进行单因素和多因素分析,确定影响DLBCL患者生存结局的变量。使用Kaplan-Meier生存曲线进行预后分析。结果580例患者中男性294例(50.7%),中位年龄(60.32±13.36)岁,总体5年OS率为56.4%。基于MaxStat统计量计算出EASIX的最佳截断值为1.17。多因素分析显示EASIX、年龄、血红蛋白、中枢累及、Ann Arbor分期是DLBCL患者的独立危险因素(P<0.05)。亚组分析结果表明,EASIX可以对BCL-2-和BCL-2+组、BCL-6-和BCL-6+组、GCB和非GCB组、ECOG PS评分<2分和≥2分组、Ann ArborⅠ/Ⅱ期和Ⅲ/Ⅳ期、IPI评分LR/LIR和HIR/HR组以及NCCN-IPI评分LR/LIR和HIR/HR组的患者进行预后再分层。结论高EASIX(>1.17)与初诊DLBCL患者的不良预后有关,且EASIX能对不同亚组的患者进行准确的预后分层。Objective To investigate the prognostic value of endothelial activation and stress index(EASIX)for patients newly diagnosed with diffuse large B-cell lymphoma(DLBCL).Methods A total of 580 patients who were diagnosed with DLBCL in six medical centers in Huaihai Lymphoma Working Group from August 2008 to March 2022 were selected and their clinical data were retrospectively analyzed.The MaxStat algorithm was used to determine the optimal cut-off value of EASIX.The Cox proportional hazard regression model was used for univariate and multivariable analysis to determine the variables influencing the survival outcomes of DLBCL patients.Kaplan-Meier survival curves were plotted for prognostic analysis,and the differences between groups were tested by log-rank.Results There were 294 men among the 580 patients(50.7%).The median age was(60.32±13.36)years,and the overall 5-year OS rate was 56.4%.Through MaxStat statistics,the optimal cut-off value of EASIX was 1.17.Multivariable analysis indicated that EASIX,age,hemoglobin,central involvement and Ann Arbor stage were the independent risk factors for DLBCL patients(P<0.05).The results of subgroup analysis showed that EASIX-based re-stratification was suitable for evaluating the prognosis of patients in the BCL-2-and BCL-2+groups,the BCL-6-and BCL-6+groups,the GCB and non-GCB groups,the ECOG PS<2 and≥2 groups,the Ann Arbor stagesⅠ/ⅡandⅢ/Ⅳ,the IPI score LR/LIR and HIR/HR groups,and the NCCN-IPI score LR/LIR and HIR/HR groups.Conclusions High EASIX(>1.17)is associated with poor prognosis for patients newly diagnosed with DLBCL,and EASIX can accurately stratify the prognosis of patients in different subgroups.

关 键 词：弥漫大B细胞淋巴瘤 EASIX 预后 初诊 多中心 回顾性 

分 类 号：R551.2[医药卫生—血液循环系统疾病]