| Objective To investigate the prognostic significance of combined detection of serum ferritin(FERR)and serum lactate dehydrogenase(LDH)in patients with newly diagnosed aggressive lymphoma.Methods The clinical data of 182 patients with newly diagnosed aggressive lymphoma collected in The Affiliated Hospital of Qingdao University were analyzed retrospectively,including 133 patients of diffuse large B cell lymphoma(DLBCL),18 patients of mantle cell lymphoma(MCL),14 patients of extranodal NK/T cell lymphoma(ENKTL)and 17 patients of peripheral T cell lymphoma(PTCL).All patients were admitted from January 2014 to March 2021 and divided into B cell group(DLBCL,MCL)and T cell group(ENKTL,PTCL).Age,sex,diagnosis,stage,B symptoms,FERR,serum LDH,white blood cell count,hemoglobin level,platelet count,β2-microglobulin,et cl were analyzed retrospectively.The best sensitivity and specificity were determined by the receiver operating characteristic curve(ROC curve).The cutoff values of FERR and serum LDH before initial chemotherapy were 376.75ng/m L and 295U/L respectively.According to this,the patients with newly diagnosed aggressive lymphoma were divided into FERR ≥ 376.75ng/m L and LDH ≥ 295U/L group(n = 47),FERR < 376.75ng/m L and LDH < 295U/L group(n = 67),and others group(n = 68)[FERR < 376.75ng/m L and LDH ≥ 295U/L group(n = 42),FERR ≥ 376.75ng/m L and LDH < 295U/L group(n =26)].Analyze the correlation between FERR,serum LDH and traditional prognostic factors such as age and stage,the influence of FERR and serum LDH on the prognosis of patients with newly diagnosed aggressive lymphoma and the influence of various factors on the prognosis of patients.We chose SPSS 25.0 software for statistical analysis,survival curve was drawn by Kaplan-Meier method,Cox regression proportional risk model was used for multivariate analysis.P<0.05 was considered to be statistically significant.Results1.Among the 182 cases of newly diagnosed aggressive lymphoma,there were 90 male patients(49.5%)and 92 female patients(50.5%).The median age at diagnosis was58 years(19-82 years),the median follow-up time was 22 months.According to Ann Arbor stage,the patients with stage Ⅰ-Ⅱ,Ⅲ-Ⅳ were 45(24.7%)and 137(75.3%),respectively.2.The area under the curve(AUC)of FERR was 0.708(95%CI: 0.608-0.807,P<0.001),the sensitivity was 0.838,the specificity was 0.537;the AUC of serum LDH was 0.644(95%CI: 0.545-0.742,P =0.007),the sensitivity was 0.730,the specificity was0.591.The AUC of the combined detection of FERR and serum LDH was 0.771(95%CI:0.672-0.869,P<0.001),the sensitivity was 0.814 and the specificity was 0.717.3.Compared with FERR < 376.75ng/m L and LDH < 295U/L group and others group,patients with FERR ≥ 376.75ng/m L and LDH ≥ 295U/L were more likely to have Ann Arbor stage Ⅲ-Ⅳ,B symptoms,IPI(international prognostic index)3-5 score,anemia,thrombocytopenia,increased β2-microglobulin and decreased serum albumin.In the evaluation of the curative effect of chemotherapy,the therapeutic effect of FERR ≥376.75ng/m L and LDH ≥ 295U/L group was much worse than that of the other groups(P<0.01).4.The survival analysis of all the aggressive lymphoma patients,B cell group and T cell group showed that the patients with FERR ≥ 376.75ng/m L and LDH ≥ 295U/L had significantly lower overall survival(OS)and progression free survival(PFS)than those with FERR < 376.75ng/m L and LDH < 295U/L respectively(P<0.05).Multivariate analysis showed that IPI score 3-5 and FERR ≥ 376.75ng/m L were independent risk factors for OS,while age > 60 years old,IPI score 3-5 and FERR ≥ 376.75ng/m L were independent risk factors for PFS.Conclusions1.The combined detection of FERR and serum LDH in newly diagnosed aggressive lymphoma had significantly predictive value.The patients with FERR ≥ 376.75ng/m L and LDH ≥ 295U/L had significantly worse OS and PFS than that of patients with FERR< 376.75ng/m L and LDH < 295U/L.2.IPI score 3-5 and FERR ≥ 376.75ng/m L were independent risk factors for OS and PFS.3.The combined detection of FERR and serum LDH is a useful prognostic marker of patients with newly diagnosed aggressive lymphoma,and the prognosis of patients with increased FERR and serum LDH was poor. |
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