Analysis Of Predicting Efficiency Of NCCN-IPI In Patients With Diffuse Large B-Cell Lymphoma

Objective:This study was to analyze the prognostic factors of patients with diffuse large B cell lymphoma, not otherwise specified. We compare the efficiency between The National Comprehensive Cancer Network (NCCN) International Prognostic Index (IPI) and IPI, to know whether the enhanced IPI can improve risk stratification.Methods:In our study,329 cases of patients with de novo diffuse large B-cell lymphoma (not otherwise specified) were retrospectively researched. Survival analysis was estimated with Kaplan-Meier curves, Log-rank test was used to compare the univariate stratification. And multivariate stratification was analyzed by Cox proportional hazard model. Kappa test was used to analyze the consistency between NCCN-IPI and IPI, and survival differences were compared according to the Kaplan-Meier curves.Result:1.The univariate analysis showed a higher prevalence in male than female (62% vs 38%) in the DLBCL (NOS), the 5-year OS and PFS had no significant difference (P=0.0.723). But age> 40,LDH ratio> 1,Ann Arbor stage(â…¢-â…£), ECOG score>2,the extranodal disease> 1 or happened in major organs, with B symptom, high NCCN-IPI and IPI had significant influence on 5-year OS and PFS (P<0.05).2.The multivariate analysis showed that high NCCN-IPI was independent poor prognostic factors for 5-year OS and PFS(P <0.05).3.NCCN-IPI consist common with IPI in the DLBCL (NOS) (weighted kappa=0.403, P=0.000). Both NCCN-IP and IPI could discriminate differences in survival stratification.4.According to the proximity of Kaplan-Meier curves by 329 cases of patients with de novo diffuse large B-cell lymphoma (NOS), the outcomes for 5-year OS of four risk stratification by NCCN-IPI were 84%, 60.3%,28.3% and 19.8%. And 5-year PFS were 72.6%,37.8%,19.5% and 0%. The outcomes for 5-year OS by IPI were 72.4%,62.1%,33.1% and 22.5%. And 5-year PFS were 62.5%,34.3%,17.8% and 13%. NCCN-IPI could also discriminate differences in risk and survival stratification compare to IPI. But NCCN-IPI did not show better discrimination in survival stratification for 5-year OS and PFS than IPI.Conclusion:1.In the patients with DLBCL (NOS), it showed that age, high LDH ratio, Ann Arbor stage, ECOG PS, extranodal disease or happened in major organs, with B symptom, high NCCN-IPI and IPI were poor facters for 5-year OS and PFS. Besides, high NCCN-IPI was independent poor prognostic factors.2. In the patients with DLBCL(NOS), the NCCN-IPI consist common with IPI. Both NCCN-IPI and IPI could discriminate differences in survival stratification. But NCCN-IPI did not show better discrimination in survival stratification than IPI.