营养状态在弥漫大B细胞淋巴瘤患者中的预后意义
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南京医科大学附属淮安第一医院血液科

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2022年淮安市第一人民医院青年创新人才项目 (No: QC202218);2018年江苏省卫生健康委员会项目 (No: H2018085)。


The prognostic significance of nutritional status in patients with diffuse large B cell lymphoma
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1.Department of Hematology,The Affiliated Huaian No People'2.'3.s Hospital of Nanjing Medical University

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2022 Young Innovative Talents Project of Huaian No.1People's Hospital (No: QC202218); 2018 Project of Jiangsu Healthcare Commission Project (No: H2018085)

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    摘要:

    目的:探讨营养状态指标包括控制营养状态(control nutritional status,CONUT)评分和预后营养指数(prognostic nutritional index,PNI)在弥漫大B细胞淋巴瘤(diffuse large B cell lymphoma,DLBCL)中的预后作用。方法:回顾性地收集105例在南京医科大学附属淮安第一医院血液科就诊的DLBCL患者的临床资料,计算出每个患者的CONUT评分和PNI,并通过ROC曲线确定截断值。CONUT评分和PNI分别以6.5和47.28作为截断值进行分组。依次进行Kaplan-Meier生存分析、单因素和多因素COX回归分析以及Spearman相关分析。结果:K-M生存曲线显示CONUT评分和PNI对患者的总生存期(overall survival,OS)具有预测作用(P<0.05)。单因素分析显示CONUT评分、PNI、IPI危险度分型、白蛋白、淋巴细胞绝对值、胆固醇均是患者OS的预后因素。多因素分析结果表明CONUT评分对DLBCL患者的OS具有独立预后作用(HR=2.742, 95%CI 1.030-7.300, P<0.05),PNI(HR=0.526, 95%CI 0.135-2.047, P=0.35)不是患者OS的独立预后因素。相关性分析结果显示两种营养状态指标呈高度负相关(r=-0.79,P<0.01)。结论:CONUT评分是DLBCL患者的独立预后因素,患者CONUT评分越高,预后越差。

    Abstract:

    Objective: To investigate the prognostic role of nutritional status indices including control nutritional status (CONUT) score and prognostic nutritional index (PNI) in patients with diffuse large B cell lymphoma (DLBCL). Methods: The clinical data of 105 patients with DLBCL at the affiliated Huaian No.1 People's Hospital of Nanjing Medical University were retrospectively collected. And the patients' CONUT score and PNI were calculated. The cut-off values of CONUT score and PNI were determined by ROC curves. CONUT score and PNI were grouped with 6.5 and 47.28 respectively. Kaplan-Meier survival analysis, univariate and multivariate COX regression analysis and Spearman correlation analysis were performed sequentially. Results: K-M survival curves demonstrated that CONUT score and PNI have a predictive effect on patients' OS (P < 0.05). Univariate analysis showed that CONUT score, PNI, IPI risk score, albumin, absolute lymphocyte count, and cholesterol were prognostic factors for patients' OS. The results of multivariate analysis showed that CONUT score had an independent prognostic effect on OS in DLBCL patients (HR=2.742, 95% CI 1.030-7.300, P<0.05) and PNI (HR=0.526, 95% CI 0.135-2.047, P=0.35) was not an independent prognostic factor for patients' OS. Correlation analysis showed a high negative correlation between the two nutritional status indicators (r=-0.79, P<0.01). Conclusions: CONUT score is an independent prognostic factor for DLBCL patients, and the higher the patient's CONUT score, the worse the prognosis.

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  • 收稿日期:2022-11-08
  • 最后修改日期:2022-11-25
  • 录用日期:2023-05-23
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