Nutritional and immune-inflammatory scoring system for predicting outcomes in newly diagnosed diffuse large B-cell lymphoma patients

作者：Yu Peng, Tingting Jiang, Shuang Chen, Xinyi Tang, Yakun Zhang, Liangmei Li, Lian Li, Longrong Ran, Xuelian Wu, Jun Li, Wei Zhang, Nanjun Li, Zailin Yang, Yao Liu · 发表于：Frontiers in Nutrition · 年份：2025 · DOI：10.3389/fnut.2025.1591508 · 被引用次数：5 · 研究领域：Lymphoma Diagnosis and Treatment、Inflammatory Biomarkers in Disease Prognosis、Multiple and Secondary Primary Cancers

Background: Diffuse large B-cell lymphoma (DLBCL) is the most common aggressive non-Hodgkin lymphoma and often carries a poor prognosis. Current prognostic systems such as the International Prognostic Index (IPI) and National Comprehensive Cancer Network (NCCN)-IPI do not incorporate patients' nutritional, immune, or inflammatory status, which may affect outcomes. Methods: We retrospectively analyzed 423 newly diagnosed DLBCL patients and collected 12 clinical indicators reflecting nutritional, immune, and inflammatory status. Patients were randomly divided into training and validation sets in a 7:3 ratio. A LASSO-Cox regression model was applied to identify variables for constructing the Nutritional and Immune-Inflammatory Scoring System (NII). The independent prognostic value of NII was evaluated using univariable and multivariable Cox regression analyses. Its added prognostic value was further assessed in combination with the IPI and NCCN-IPI. Results: T cells. A high NII (≥ 6) effectively identifies high-risk DLBCL patients and serves as an independent prognostic factor beyond other clinical characteristic, IPI, and NCCN-IPI. DLBCL patients with a high NII (≥ 6) exhibit significantly adverse clinical features, including older age, lower frequency of the non-GCB subtype, advanced Ann Arbor stage (III/IV), poor performance status (ECOG PS ≥ 2), involvement of ≥ 2 extranodal sites, presence of B symptoms, elevated lactate dehydrogenase (LDH) levels, and classification into h...