A Novel Prognostic Model Establishment and Treatment Efficacy Analysis for Primary Pulmonary Non-Hodgkin’s Lymphoma

LI Hui; JIANCHENG Li; FENG Liu; DI Wu; CHUANBEN Chen; JINLUAN Li

doi:10.11999/JEIT250874

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LI Hui, JIANCHENG Li, FENG Liu, DI Wu, CHUANBEN Chen, JINLUAN Li. A Novel Prognostic Model Establishment and Treatment Efficacy Analysis for Primary Pulmonary Non-Hodgkin’s Lymphoma[J]. Journal of Electronics & Information Technology. doi: 10.11999/JEIT250874

Citation:

LI Hui, JIANCHENG Li, FENG Liu, DI Wu, CHUANBEN Chen, JINLUAN Li. A Novel Prognostic Model Establishment and Treatment Efficacy Analysis for Primary Pulmonary Non-Hodgkin’s Lymphoma[J]. Journal of Electronics & Information Technology. doi: 10.11999/JEIT250874

Citation:

LI Hui, JIANCHENG Li, FENG Liu, DI Wu, CHUANBEN Chen, JINLUAN Li. A Novel Prognostic Model Establishment and Treatment Efficacy Analysis for Primary Pulmonary Non-Hodgkin’s Lymphoma[J]. Journal of Electronics & Information Technology. doi: 10.11999/JEIT250874

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A Novel Prognostic Model Establishment and Treatment Efficacy Analysis for Primary Pulmonary Non-Hodgkin’s Lymphoma

doi: 10.11999/JEIT250874 cstr: 32379.14.JEIT250874

LI Hui¹,
JIANCHENG Li¹,
FENG Liu²,
DI Wu³,
CHUANBEN Chen^{1
,
,},
JINLUAN Li^{1
,
,}

1.
Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou 350014, China
2.
The First Affiliated Hospital of Fujian Medical University, Fuzhou 350009, China
3.
Fuzhou Pulmonary Hospital of Fujian, Fuzhou 350008, China

Funds: Fujian Research and Training Grants for Youth and Middle-aged Leaders in Healthcare, 2022, Natural Science Foundation of Fujian Province, 2025J01221, Fujian Provincial Clinical Research Center for Cancer Radiotherapy and Immunotherapy, 2020Y2012

Received Date: 2025-08-31
Accepted Date: 2026-01-22
Rev Recd Date: 2026-01-22

Available Online: 2026-03-04

Abstract

Abstract

Objective At present, there are few related studies on primary pulmonary non-Hodgkin's lymphoma (PPL), mainly single-center and retrospective studies. Therefore, there is no widely used and recognized prognostic index and treatment decision for PPL. This study aims to establish and verify a novel International Prognostic Index (IPI) of PPL by using the data of cancer population in the United States and Chinese multi-centers, and to compare the curative effects of different treatment methods. So as to predict the clinical prognosis and to provide new and effective ideas for making treatment decisions of PPL. Methods In this study, the clinical data of patients diagnosed with PPL from 2000 to 2019 in the Surveillance, Epidemiology, and End Results (SEER) database of America and from 2010 to 2021 in 3 tertiary hospitals in China were included. Cox proportional hazards regression model was used to determine independent prognostic factors and a nomogram was established to predict cancer-specific survival (CSS). The model was validated using the Concordance-index (C-index) and calibration curve. Combining nomogram with IPI, a novel prognostic index was established, risk stratified and the 3-year overall survival (OS) rate was calculated. The inverse probability of treatment weighting (IPTW) was used to eliminate confounding factors, and Kaplan-Meier curve and Log-rank test were used for survival analysis. Results and Discussions Finally, a total of 4,313 cases from the SEER database and 107 cases from the Chinese multi-center were included this study. The multivariate Cox regression results showed that the independent prognostic factors of PPL included age (P<0.001; hazard ratio [HR], 1.078; 95% confidence interval [CI], 1.072–1.084), Ann Arbor stage (P<0.001), sex (P<0.001; HR, 0.719; 95% CI, 0.624–0.829), primary site (P=0.037), pathological type (P<0.001), B symptom (p=0.012; HR, 0.944; 95% CI, 0.773–0.997), surgery (P<0.001; HR, 1.453; 95% CI, 1.221–1.728), chemotherapy (P<0.001; HR, 0.742; 95% CI, 0.631–0.872), marital status (P<0.001). Based on these independent prognostic factors, a nomogram with 3, 5, and 10 years of CSS was established. By combining nomogram and IPI, we established a prognostic model of PPL, and its C-index was 0.932. By defining risk factors and stratifying the model, we established a novel prognostic index for PPL. The risk parameters were defined as: age > 60 years, Ann Arbor stage III/IV, serum LDH level >1 times normal level, performance status score >2, number of extranodal invasion >1, male, except mucosa-associated lymphoid tissue (MALT), positive B symptoms, and not receive cancer therapy; the definition of risk stratification and their 3-year OS rate were: low-risk group (0-2 risk factors) 96.97%, low-mediate risk group (3-4 risk factors) 82.61%, high-mediate risk group (5 risk factors) 50%, and high risk group (6-9 risk factors) 11.11%, (P<0.001). Regarding the efficacy comparison of treatment methods, both the American and Chinese data showed that chemotherapy significantly reduced the CSS of patients with primary pulmonary MALT lymphoma (P<0.001). There were no significant differences between the efficacy of surgery and radiotherapy both in primary pulmonary MALT lymphoma and diffuse large B-cell lymphoma (P>0.05). Conclusions First, this study established a novel prognostic index for PPL based on the data of the American cancer population and the Chinese multi-center cohort. The parameters were age, stage, serum LDH level, performance status score, and numbers of extranodal invasion. The index has excellent predictive ability and accuracy. Through risk stratification of this index, the 3-year OS rate of different risk groups were obtained. Finally, the efficacy analysis suggested that chemotherapy may be detrimental the CSS of patients with primary pulmonary MALT lymphoma. In addition, there was no significant difference of surgery and radiotherapy both in primary pulmonary MALT lymphoma and diffuse large B-cell lymphoma.
- Primary Pulmonary Non-Hodgkin’s Lymphoma,
- Novel prognostic index,
- Treatment efficacy,
- Multi-center analysis,
- Prognostic model

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References(45)

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