Abstract
OBJECTIVES: The objectives of the study are to develop and validate a novel prognostic model for extranodal natural killer/T-cell lymphoma (ENKTCL) by integrating clinical and pathological parameters. MATERIAL AND METHODS: We retrospectively analyzed 106 patients with ENKTCL (2008-2020) from the Department of Pathology of Yantai Yuhuangding Hospital and the Affiliated Hospital of Nantong University, constructing the novel international prognostic index (NIPI) model through multivariable Cox regression of immunohistochemistry (IHC) markers (age, MTP53, Ki-67, lactate dehydrogenase, hemoglobin, platelet-tolymphocyte ratio) and quantitative dot blot (QDB) tumor microenvironment features. RESULTS: The model demonstrated significant risk stratification (P < 0.001) with a 3-year area under the curve of 0.72 (IHC) and 0.80 (QDB), outperforming Ann Arbor staging (P > 0.05) and existing international prognostic index (P = 0.00036)/natural killer lymphoma prognostic index (P = 0.00017) models. The QDB-based implementation showed superior prognostic discrimination (P = 0.00014), highlighting its potential for precise individualized therapy. CONCLUSION: NIPI provides improved risk stratification for ENKTCL, and QDB-based analysis offers enhanced precision in individualized therapy. This model addresses the unmet needs for ENKTCL prognostication and warrants further multicenter validation.