Retrospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 16, 2021; 9(32): 9825-9834
Published online Nov 16, 2021. doi: 10.12998/wjcc.v9.i32.9825
Systemic immune inflammation index, ratio of lymphocytes to monocytes, lactate dehydrogenase and prognosis of diffuse large B-cell lymphoma patients
Xiao-Bo Wu, Shu-Ling Hou, Hu Liu
Xiao-Bo Wu, Shu-Ling Hou, Hu Liu, Department of Lymphoma, Cancer Center, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan 030032, Shanxi Province, China
Xiao-Bo Wu, Shu-Ling Hou, Hu Liu, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
Author contributions: Wu XB designed the research study; Hou SL performed the research; Liu Hu contributed new reagents and analytic tools; Wu XB analyzed the data and wrote the manuscript; and all authors have read and approve the final manuscript.
Institutional review board statement: The study was reviewed and approved by the Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital Institutional Review Board.
Informed consent statement: All study participants provided informed written consent prior to study enrollment.
Conflict-of-interest statement: No conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xiao-Bo Wu, MMed, Attending Doctor, Department of Lymphoma, Cancer Center, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, No. 99 Longcheng Street, Taiyuan 030032, Shanxi Province, China. maviswxb@163.com
Received: August 18, 2021
Peer-review started: August 18, 2021
First decision: September 29, 2021
Revised: October 8, 2021
Accepted: October 25, 2021
Article in press: October 25, 2021
Published online: November 16, 2021
Abstract
BACKGROUND

In malignant tumors, inflammation plays a vital role in the development, invasion, and metastasis of cancer cells. Diffuse large B-cell lymphoma (DLBCL), the most common malignant proliferative disease of the lymphatic system, is commonly associated with inflammation. The international prognostic index (IPI), which includes age, lactate dehydrogenase (LDH), number of extranodal lesions, Ann Arbor score, and Eastern Cooperative Oncology Group (ECOG) score, can evaluate the prognosis of DLBCL. However, its use in accurately identifying high-risk patients and guiding treatment is poor. Therefore, it is important to find novel immune markers in predicting the prognosis of DLBCL patients.

AIM

To determine the association between the systemic immune inflammation index (SII), ratio of lymphocytes to monocytes (LMR), ratio of LMR to LDH (LMR/LDH), and prognosis of patients with DLBCL.

METHODS

A total of 68 patients diagnosed with DLBCL, treated in our hospital between January 2016 and January 2020, were included. χ2 test, Pearson’s R correlation, Kaplan Meier curves, and Cox proportional risk regression analysis were used. The differences in the SII, LMR, and LMR/LDH among patients with different clinicopathological features were analyzed. The differences in progression-free survival time among patients with different SII, LMR, and LMR/LDH expressions and influencing factors affecting the prognosis of DLBCL patients, were also analyzed.

RESULTS

The LMR and LMR/LDH in patients with Ann Arbor stage III–IV, ECOG score ≥ 2, and SII, IPI score 2–5 were significantly higher than those of patients with Ann Arbor stage I-II and ECOG score < 2 (P < 0.05). Patients with high SII, LMR, and LMR/LDH had progression-free survival times of 34 mo (95%CI: 32.52–38.50), 35 mo (95%CI: 33.42–36.58) and 35 mo (95%CI: 33.49–36.51), respectively, which were significantly lower than those with low SII, LMR, and LMR/LDH (P < 0.05); the SII, LMR, and LMR/LDH were positively correlated (P < 0.05). Cox proportional risk regression analysis showed that the SII, LMR, and LMR/LDH were influencing factors for the prognosis of DLBCL patients (hazard ratio = 1.143, 1.665, and 1.704, respectively; P < 0.05).

CONCLUSION

The SII, LMR, and LMR/LDH are related to the clinicopathological features of DLCBL, and they also influence the prognosis of patients with the disease.

Keywords: Systemic immune inflammation index, Ratio of lymphocytes to monocytes, Lactate dehydrogenase, Diffuse large B-cell lymphoma, Prognosis

Core Tip: We need find effective biomarkers to predict the prognosis and recurrence of diffuse large B-cell lymphoma among patients. Lactate dehydrogenase and systemic immune inflammation index can be used as a prognostic indicator.