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

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.