Comparison and exploration of the prognostic value of the advanced lung cancer inflammation index, prognostic nutritional index, and systemic immune-inflammation index in newly diagnosed diffuse large b-cell lymphoma

Abstract

Background: The international prognostic index (IPI) is widely used as an indicator for evaluating the clinical prognosis of diffuse large B-cell lymphoma (DLBCL). However, more precise prognostic indicators are needed. This study aimed to evaluate the prognostic significance of the advanced lung cancer inflammation index (ALI), prognostic nutritional index (PNI), and systemic immune-inflammation index (SII) in DLBCL. Methods: A total of 117 patients with newly diagnosed DLBCL were included in this study. Receiver operating characteristic (ROC) curve analysis was used to determine the optimal cut-off values for the ALI, PNI, and SII to predict survival, and patients were stratified into high and low groups. Cox regression analysis and the Kaplan-Meier method were used to assess the prognostic ability of these indexes. Results: The optimal cut-offs for the ALI, PNI, and SII were 31.26, 36.48, and 486.76, respectively. The ALI had the highest area under the curve (AUC). The high ALI or PNI group had better 5-year overall survival (OS) than the low ALI (73% vs. 53%, P<0.001) or PNI (60% vs. 45%, P<0.001) group, and the low SII group had better 5-year OS than the high SII group (67% vs. 62%, P=0.034). Although all 3 parameters were associated with OS in univariate analyses, only the ALI and PNI were independent factors for OS in multivariate analyses. We found that when DLBCL patients were classified according to IPI combined with ALI, PNI, or SII, respectively, there were more obvious differences in OS among different types. Conclusions: The ALI and PNI may be easily available markers to predict clinical outcomes in DLBCL patients. SII predicted OS only in univariate analysis.