Association of APOC1 levels and nutritional indices with clinicopathological features and prognostic value in patients with DLBCL

Objective: This study aims to unravel the relationship between apolipoprotein C1 (APOC1) levels, prognostic nutritional index (PNI), and clinicopathological characteristics in patients with diffuse large B-cell lymphoma (DLBCL) and their prognostic predictive value. Methods: This study retrospectively analyzed clinical data from 55 DLBCL patients and 50 healthy screening volunteers. APOC1 levels and the PNI were compared between groups, along with their association with DLBCL’s clinicopathological features. Patients were stratified into favorable and poor prognosis groups based on the International Prognostic Index (IPI), with APOC1 and PNI compared between subgroups. Kaplan-Meier curves were used to analyze the impact of high and low expression levels of APOC1 and PNI on progression-free survival (PFS) and overall survival (OS) in DLBCL patients. Multivariate logistic regression identified risk factors for poor prognosis, while Receiver Operating Characteristic (ROC) curves assessed the predictive value of APOC1 and PNI for DLBCL outcomes. Results: DLBCL patients had higher APOC1 levels and lower PNI than controls. Patients with advanced-stage (III-IV) disease showed significantly increased APOC1 and decreased PNI compared to early-stage (I-II) cases. DLBCL patients with high APOC1 expression and low PNI showed left-shifted PFS and OS curves ( P < 0.05). Both elevated APOC1 and reduced PNI were independent risk factors for poor prognosis, with Area Under the Curve (AUC)s of 0.836 and 0.779, respectively. Their combined predictive value improved, suggesting potential utility in prognosis assessment. Conclusion: APOC1 levels and PNI are significantly correlated with higher disease risk in DLBCL, and their combined evaluation may help improve risk assessment.