Value of combined detection of CRP,D-dimer,NLR,and LMR in prognostic assessment of patients with diffuse large B-cell lymphoma
WANG Qiyan
YUE Jungang
YANG Mei
LAN Yumei
LI Dan
Abstract：Objective To explore the value of combined detection of inflammatory,coagulation,and immune indices in the prognostic assessment of diffuse large B-cell lymphoma(DLBCL).Methods Clinical data of 120 newly diagnosed DLBCL patients were retrospectively analyzed.The relationships between C-reactive protein(CRP),D-dimer,neutrophil-to-lymphocyte ratio(NLR),lymphocyte-to-monocyte ratio(LMR),and patient survival were evaluated.ROC curves were used to determine optimal cutoff values,Cox regression analysis identified independent prognostic factors,and a combined prediction model was constructed and compared with the international prognostic index(IPI).Results Based on ROC curve analysis,the optimal cutoff values were:CRP>10 mg/L,D-dimer>500 ng/mL,NLR≥3,and LMR<2,all of which were independent prognostic factors(HR:2.35,1.98,1.75,and 0.54,respectively;all P<0.05).The combined prediction model had a C-statistic of 0.78,significantly higher than the IPI score(0.71),with an area under the ROC curve of 0.82,which was superior to the IPI score(0.74)(P=0.023).When the model was combined with the IPI score,the predictive accuracy for patient prognosis was further improved(AUC=0.87).The model performed consistently across different IPI score subgroups.Interaction analysis showed that the combined elevation of CRP and D-dimer significantly increased the prognostic risk(HR=3.25,P＜0.001).Conclusion Combined detection of inflammatory,coagulation,and immune indices is superior to the traditional IPI score and provides a new tool for the prognostic assessment of DLBCL patients,which is conducive to formulating individualized clinical treatment strategies.
Keywords：Diffuse large B-cell lymphomaC-reactive proteinD-dimerNeutrophil-to-lymphocyte ratioLymphocyte-to-monocyte ratioPrognosis
Publication Date：2025-12-28
Online Publishing Date：2026-01-28(First online date of this platform, not the publication date of the document)
Pages：7( 1599-1605 )