| Background Extranodal NK/T cell lymphoma, nasal type, is one kind of Non-Hodgkin's lymphoma(NHL) whose primary focus always falls on the extranodal tissues.Compared with other kinds of NHL, extranodal NK/T cell lymphoma has a more aggressive clinical characteristics and a worse clinical outcome. The comprehensive therapies used across the world have not been satisfied by oncological docotors and patients. In order to help doctors to predict the curative effect and clinical outcome of extranodal NK/T cell lymphoma patients, it's necessary to find prognostic factors which are specially for this kind of NHL.Nowadays, we use lots of prognostic factors which are applied to all kinds of lymphomas. Among them, only several have been confirmed that they have closely relationship with Extranodal NK/T cell lymphoma, such as high level of LDH, EBV+and so on. Recently, many research centres and groups are trying to find new prognostic factors for this kind of NHL at gene and protein levels both in the laboratory and clinically. However, many of the latest prognostic factors are so expensive to afford and it is difficult to get them from the biopsy from patients.Moreover, they are need to be tested and confirmed through multi-centre large samples data across the world. Collecting the clinical data which can be gotten easily through the process of therapy and trying to find out whether they can predict the prognosis of extranodal NK/T cell lymphoma will be a cheap and efficient way to help doctors make clinical strategies for each patients.Blood routin examination is a basic test on the clinical and the results of this test can be gotten easily throughout the comprehensive therapies. It is known to all that the absolute account and percentage of neutrophil and monocyte is related to inflammation in human body, which is the same with the absolute accout and percentage of lymphocyte to immune state. For extranodal NK/T cell lymphoma,nasal type, inflammation and immune system state are two significant elements for the microenvironment for tumor to development as while as extranodal NK/T cell lymphoma. It has been proved that the elevation of the ratio between neutrophil and lymphocyte will predict worse outcome of many kinds of tumors, such as esophagus cancer, colorectal cancer, non-small cell lung cancer, advanced gastric carcinoma and so on. The absolute account of neutrophil, lymphocyte and monocyte have been shown that can be the independent prognostic factors for Diffuse large B cell Lymphoma(DLBCL), while there are no reports of similar study with extranodal NK/T cell lymphoma, nasal type.Methods This is retrospective study for 133 cases of extranodal NK/T cell lymphoma,nasal type, which were collected from the clinical centre for malignancy lymphoma in the First Affiliated Hospital of Zhengzhou University during September 2010 to September 2015. In this study, Pearson simple correlation, Spearman correlation,simple linear regression model, Curve Estimation, Logistic regression, Optimal scaling, Receiver operating characteristic curve and Kaplan Meier to explore the relationship of over all survival(OS), progression free survival(PFS), curative effect with age, WBC, HBG, LDH, ?2-MG, ANC, ALC, AMC, LNR, LMR, NMR,sex,stage, IPI/aa IPI score and B symptoms respectively. Establish a new prognostic model using the positive indexes and compare the new model with the present prognostic models.Results LDH and ?2-MG are related with OS and PFS through Pearson simple correlation analysis;Sex, stage and IPI/aa IPI score are related with curative effect after 2 cycle of chemotherapy through Spearman correlation analysis;LDH, ?2-MG and ALC are related with OS and PFS through Regression analysis,while the detailed model need multi-centre large sample data to confirm;Age, WBC, HBG, ANC, ALC, AMC, LNR, LMR and NMR can predict curative effect through Receiver Operating Characteristic Curve analyze. With the cutoff values of Age, WBC, HBG, ANC, ALC, LNR, NMR, they will show out significant statistical differences in OS and PFS.Use the positive indicators: Age?ALC?LNR?WBC?HBG?LDH??2-MG and set up the BREPI( Blood Routine Examination Prognostic Index) Model. According to BREPI Model, a survivorship curve which is divided into 4 groups clearly can be gotten.Conclusions According to this study, it has shown us that LDH, ?2-MG, ALC, Age, WBC,HBG, ANC, ALC, LNR, NMR, stage, IPI/aa IPI scorin and sex can be the curative effect and prognostic factors for extranodal NK/T cell lymphoma. BREPI Model is better to predict the prognosis of extranodal NK/T cell lymphoma than IPI/aa IPI model and Ann Arbor staging system while this conclusion still need to be confirm by more clinical data. |
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