Evidence map›Paper›PMID 42750067›Full record

ArticleBiomarker research2026

Metabolic-inflammatory index CTI identifies high-risk early-stage natural killer/T-cell lymphoma and informs a novel prognostic model.

Qiuhui Jiang, Peng Xu, Huijuan Zhong, Shuhui Fu, Liangjie Wang, Weili Zhao, Shu Cheng, Jie Zha, Bing Xu

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Biomarker research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02631239 (The Efficacy and Safety of Etoposide, Dexamethasone, Peg-asparaginase or Plus Methotrexate With Sandwiched Radiotherapy in the Treatment of Stage I to II Extranodal Natural Killer/T-Cell Lymphoma, Nasal Type), which is not on this map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

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2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02631239 phase3unknown statusnot on this map

The Efficacy and Safety of Etoposide, Dexamethasone, Peg-asparaginase or Plus Methotrexate With Sandwiched Radiotherapy in the Treatment of Stage I to II Extranodal Natural Killer/T-Cell Lymphoma, Nasal Type

TypeinterventionalSponsorRuijin HospitalRan2016 to 2022Enrolled256ConditionsExtranodal NK/T-cell Lymphoma, Nasal TypeArmsMethotrexate, Etoposide, Dexamethasone, Pegaspargase, Radiotherapy
3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Qiuhui Jiang *Department of Hematology, School of Medicine, The First Affiliated Hospital of Xiamen University and Institute of Hematology, Xiamen University, Xiamen, China.ORCID http://orcid.org/0000-0002-2613-706X
Peng Xu *Department of Hematology, School of Medicine, The First Affiliated Hospital of Xiamen University and Institute of Hematology, Xiamen University, Xiamen, China.
Huijuan Zhong *State Key Laboratory of Medical Genomics, Shanghai Institute of Hematology, National Research Center for Translational Medicine at Shanghai, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Shuhui FuDepartment of Hematology, School of Medicine, The First Affiliated Hospital of Xiamen University and Institute of Hematology, Xiamen University, Xiamen, China.
Liangjie WangDepartment of Hematology, School of Medicine, The First Affiliated Hospital of Xiamen University and Institute of Hematology, Xiamen University, Xiamen, China.
Weili ZhaoState Key Laboratory of Medical Genomics, Shanghai Institute of Hematology, National Research Center for Translational Medicine at Shanghai, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Shu ChengState Key Laboratory of Medical Genomics, Shanghai Institute of Hematology, National Research Center for Translational Medicine at Shanghai, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China. cs11123@rjh.com.cn.
Jie ZhaDepartment of Hematology, School of Medicine, The First Affiliated Hospital of Xiamen University and Institute of Hematology, Xiamen University, Xiamen, China. zhajie@xmu.edu.cn.
Bing XuDepartment of Hematology, School of Medicine, The First Affiliated Hospital of Xiamen University and Institute of Hematology, Xiamen University, Xiamen, China. xubingzhangjian@126.com.

Funding

National Natural Science Foundation of China 82570231Noncommunicable Chronic Diseases-National Science and Technology Major Project 2026ZD0553900, 2023ZD0500700
6 · The paper itself

Abstract

backgroundThe prognostic heterogeneity of early-stage natural killer/T-cell lymphoma (NKTCL) remains inadequately defined. This study aimed to investigate the prognostic value and potential biological relevance of the metabolic-inflammatory biomarkers in early-stage NKTCL.

methodsWe conducted a secondary analysis on 166 patients with early-stage NKTCL from a multicenter clinical trial (NCT02631239). C-reactive protein-triglyceride-glucose Index (CTI) was calculated as: 0.412* Ln (CRP [mg/L]) + Ln (TG [mg/dL] × FPG [mg/dL])/2. Cox proportional hazards models and restricted cubic spline analyses were applied to assess the association and dose-response relationship between CTI and overall survival (OS). Mechanistic insights were explored through animal experiments and clinical lymphocyte-subset analyses. Independent prognostic factors were identified using multivariable Cox regression, and a composite prognostic model incorporating CTI, body mass index (BMI), and albumin (ALB) was subsequently developed and internally evaluated.

resultsHigh CTI was independently associated with inferior OS in patients with early-stage NKTCL, with a significant linear dose-response relationship. Patients with high CTI had a higher incidence of B symptoms and elevated lactate dehydrogenase and β2-microglobulin levels. A simplified CTI-BMI-ALB prognostic model demonstrated moderate predictive performance for 1-, 3-, and 5-year OS, with AUCs of 0.71, 0.71, and 0.69, respectively, and an overall C-index of 0.69 (95% CI: 0.59-0.79). In the present cohort, the CTI-BMI-ALB model showed improved discriminative performance compared with conventional prognostic indices and provided additional survival stratification among patients classified as low-risk or favorable-risk by these indices within this cohort. In vivo experiments showed that the Gubra-Amylin NASH diet-induced metabolic-inflammatory state with elevated CTI levels was associated with accelerated lymphoma progression, reduced intratumoral CD8

conclusionCTI is an independent prognostic biomarker in early-stage NKTCL, reflecting systemic metabolic-inflammatory and immune dysregulation. The CTI-BMI-ALB model, which integrates inflammatory, nutritional, and metabolic dimensions, showed potential for complementary risk stratification beyond conventional prognostic indices and warrants further validation before broader clinical application.

Indexed as

C-reactive protein-triglyceride-glucose indexImmune dysregulationMetabolic inflammationNatural killer/T-cell lymphomaPrognosisTumor microenvironment

Identifiers

PMID42750067
PMCPMC13579890

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