Clinical Significance Of NLR,PLR And LDH In Peripheral Blood Of Patients With Diffuse Large B-cell Lymphoma

BackgroundDiffuse large B-cell lymphoma(DLBCL)is the most common type of aggressive lymphoma in adults,with great heterogeneity in clinical manifestations and prognosis.DLBCL with a high degree of malignancy and progresses quickly.The gold standard diagnosis is pathological biopsy,Therefore,when the patient gets a definite diagnosis,the lesion metastasis may have occurred and in the advanced stage of the disease.According to the Ann Arbor staging standard,IPI(International Prognostic Index)score is used to evaluate the prognosis of the tumor,CT or PET-CT is required to assess the tumor distribution,which is expensive and complicated,moreover,the existing staging and stratification methods are still unable to fully identify a few refractory lymphomas.Therefore,it is very meaningful to seek simple,easy-to-obtain,rapid and accurate laboratory indicators for the identification of early DLBCL and the preliminary staging and prognosis stratification of tumors.ObjectiveTo investigate the differences in the ratio of neutrophils to lymphocytes(NLR),platelet to lymphocyte(PLR),lactate dehydrogenase(LDH)in peripheral blood of patients with DLBCL,as well as the differences between different stages and prognostic stratified levels,the correlation with the diagnosis and stage of the disease.MethodsDLBCL who admitted to the Hematology Department of the First Affiliated Hospital of Xinxiang Medical University from October 2018 to September 2020 and healthy during the same period were collected.Clinical data including: the levels of NLR,PLR and LDH in peripheral blood,whether there are differences between the two groups,different stages and different prognostic stratification.Establishing receiver operating characteristic(ROC)curve,and the area under the curve(AUC)was analyzed to compare the correlation of NLR,PLR,LDH and the combination of the three with the diagnosis of DLBCL,as well as the value of the combination of the three tests for the differential different stages.SPSS23.0 soft ware was used for statistical analysis of the data,and t test was used for comparison between groups.Establish ROC curve,and calculate the area under the curve(AUC).ROC curve of the three combination: by establishing a logistic regression model,calculating the probability value,fitting the ROC curve.Results1.According to the inclusion and exclusion criteria,a total of 81 patients and 85 healthy people were enrolled,and there were significant differences in the levels of NLR,PLR and LDH between the two groups(P<0.05);According to Ann Arbor staging: Ⅰ～Ⅱ 27 patients,Ⅲ～Ⅳ 54 patients,there were significant differences in the levels of NLR,PLR and LDH between different stages(P<0.05);According to the IPI prognostic scoring system,low risk 28,low and medium risk 15,medium and high risk 22,high risk 16.There was no difference between groups and within groups(P>0.05).2.ROC curves:(1)Lymphoma group and the healthy control group: the AUC of NLR,PLR,LDH was 0.78,0.788,0.866,the combination of the three was 0.916,respectively,and the cut-off value was 2.435,168.635,186.5ng/ml,respectively.Pair comparison showed that the sensitivity and specificity of the combination were higher than that of PLR alone(P<0.05).(2)Different stages: the AUC of NLR,PLR,LDH was 0.597,0.621,0.662,respectively,and the combined was 0.691.The cut-off value was 3.95,251.47,267ng/ml,respectively.The sensitivity,specificity was significant(P<0.05),and there was no significant difference in accuracy(P>0.05).Pair comparison showed that the sensitivity of LDH alone was higher than that of NLR,PLR alone(P<0.05).The specificity of NLR,PLR alone was higher than LDH alone(P<0.05).ConclusionNLR,PLR,and LDH were significantly increased in patients who with diffuse large B-cell lymphoma,and had a certain correlation with the stage,however,there was no significant difference between different prognostic stratification.There was certain correlation between the NLR,PLR,LDH and the diagnosis of DLBCL.NLR,PLR,LDH and the combination of the three all have a certain value in the staging of DLBCL.