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    内皮活化和应激指数对结外NK/T细胞淋巴瘤患者生存的预测意义

    Prediction of survival in extranodal NK/T-cell lymphoma patients based on endothelial activation and stress index

      摘要
    • 摘要: 目的 评估内皮活化和应激指数(EASIX)对结外NK/T细胞淋巴瘤(ENKTL)患者生存的预测意义。方法 回顾性分析2014年8月—2022年12月就诊于徐州医科大学附属医院的ENKTL患者的临床资料。卡方检验分析EASIX与ENKTL患者临床特征的相关性,Kaplan-Meier生存曲线分析不同EASIX组患者的总生存期(OS)和无进展生存期(PFS),单因素与多因素分析不同因素对ENKTL患者的OS和PFS影响。结果 共纳入72例患者,根据受试者工作特征(ROC)曲线分析,EASIX的最佳截止值为1.05,以此为界分为高EASIX组(≥1.05)和低EASIX组(<1.05)。高EASIX更倾向于发生在Ann Arbor分期较晚、乳酸脱氢酶(LDH)水平升高、血小板减少、低白蛋白血症、PINK-E评分中/高危的患者中。生存分析显示,高EASIX组患者的OS和PFS较低EASIX组患者均明显缩短(P<0.001)。单因素分析显示,B症状、分期晚、LDH水平升高、美国东部肿瘤协作组体能状况评分(ECOG PS)(≥2)、低白蛋白血症、原发鼻外、自然杀伤细胞淋巴瘤预后指数(PINK-E)(3-5)、EB病毒DNA (EBV DNA)评分及高EASIX影响患者预后。多因素分析显示,原发鼻外及高EASIX是OS和PFS的独立不良预后因素。亚组分析结果表明,EASIX对Ann Arbor分期Ⅰ/Ⅱ期和Ⅲ/Ⅳ期、ECOG PS评分<2分和≥2分、原发鼻部和原发鼻外的患者进行预后再分层。结论 高EASIX是初诊ENKTL患者不良预后的独立危险因素。

       

      Abstract: Objective To evaluate the predictive significance of endothelial activation and stress index (EASIX) on survival in patients with extranodal NK/T-cell lymphoma (ENKTL).Methods Retrospective analysis was conducted using clinical data from ENKTL patients who were admitted to the Affiliated Hospital of Xuzhou Medical University from August 2014 to December 2022. The correlation between EASIX and clinical characteristics of ENKTL patients was analyzed by the chi-square test. Kaplan-Meier survival analysis was performed to evaluate the overall survival (OS) and progression-free survival (PFS) of patients in different EASIX groups. Univariate and multivariate analyses were conducted to assess the impact of different factors on OS and PFS in ENKTL patients.Results A total of 72 patients were included. Receiver operating characteristic (ROC) curves revealed that the optimal cutoff value for EASIX was 1.05. Accordingly, the patients were divided into two groups: a high EASIX group (≥1.05) and a low EASIX group (<1.05). Patients with high EASIX were more likely to present with advanced Ann Arbor stage, elevated lactate dehydrogenase (LDH) levels, thrombocytopenia, hypoalbuminemia, and intermediate/high-risk PINK-E scores. Survival analysis indicated that patients in the high EASIX group had significantly shorter OS and PFS than the low EASIX group (P<0.001). Univariate analysis showed that B symptoms, advanced stage, elevated LDH levels, Eastern Cooperative Oncology Group Performance Status (ECOG PS) ≥2, hypoalbuminemia, primary extranasal involvement, PINK-E score (3-5), EB virus DNA (EBV DNA) score, and high EASIX all influenced prognosis. Multivariate analysis revealed that primary extranasal involvement and high EASIX were independent adverse prognostic factors for OS and PFS. Subgroup analysis indicated that EASIX further stratified prognosis for patients with Ann Arbor stages I/II and III/IV, ECOG PS <2 and ≥2, and primary nasal and extranasal involvement.Conclusions High EASIX is an independent risk factor for poor prognosis in newly diagnosed ENKTL patients.

       

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