{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T04:53:43Z","timestamp":1781585623387,"version":"3.54.5"},"reference-count":35,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,5,10]],"date-time":"2026-05-10T00:00:00Z","timestamp":1778371200000},"content-version":"vor","delay-in-days":9,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>With increasing recognition of the prognostic role of neutrophils in malignancies, this study investigated the clinical significance of neutrophil elastase (NE) expression in diffuse large B\u2010cell lymphoma (DLBCL).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Eighty\u2010seven patients with newly diagnosed primary DLBCL treated at Yancheng First People's Hospital between June 2020 and September 2024 were included. NE expression in tumor tissues was assessed by immunohistochemistry. Clinical and pathological characteristics were compared between NE\u2010positive (NE\n                      <jats:sup>+<\/jats:sup>\n                      ) and NE\u2010negative (NE\n                      <jats:sup>\u2212<\/jats:sup>\n                      ) groups, and the association between NE expression and prognosis was analyzed. In\u00a0vitro experiments using SU\u2010DHL\u20104 cells evaluated the effects of NE and the NE inhibitor sivelestat on cell proliferation, apoptosis, and the expression of apoptosis\u2010related proteins.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Positive NE expression was detected in 51.7% of DLBCL specimens. Compared with the NE\n                      <jats:sup>\u2212<\/jats:sup>\n                      group, the NE\n                      <jats:sup>+<\/jats:sup>\n                      group showed a higher proportion of patients with International Prognostic Index (IPI) scores &gt;\u20092 and intermediate\u2013high\/high\u2010risk Ann Arbor stages. Ki\u201067 expression was also elevated in the NE\n                      <jats:sup>+<\/jats:sup>\n                      group. Patients with NE positivity had significantly shorter overall survival (OS) and progression\u2010free survival (PFS) in the overall cohort, with similar findings in the non\u2010GCB subgroup (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). Univariate analysis identified LDH level, B symptoms, Ann Arbor stage, NE expression, IPI score, and treatment regimen as prognostic factors. Multivariate analysis confirmed elevated LDH, positive NE expression, IPI score &gt;\u20092, and non\u2010R\u2010CHOP therapy as independent predictors of poor OS. In\u00a0vitro, NE promoted SU\u2010DHL\u20104 cell proliferation and suppressed apoptosis\u2010related protein activation, whereas sivelestat inhibited proliferation, induced apoptosis, and reversed the effects of NE.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>NE expression is associated with an unfavorable prognosis in DLBCL and may serve as a potential prognostic biomarker. Moreover, NE promotes lymphoma cell proliferation and inhibits apoptosis, effects that can be effectively reversed by sivelestat.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cam4.71847","type":"journal-article","created":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T04:36:09Z","timestamp":1778474169000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Neutrophil Elastase as a Prognostic Biomarker and Driver of Tumor Progression in Diffuse Large B\u2010Cell Lymphoma"],"prefix":"10.1002","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-0270-5335","authenticated-orcid":false,"given":"Xinyu","family":"Zheng","sequence":"first","affiliation":[{"name":"Cancer Institute, Cellular Therapeutics School of Medicine Xuzhou Medical University  Xuzhou Jiangsu China"},{"name":"The Yancheng Clinical College of Xuzhou Medical University  Yancheng China"},{"name":"Department of Hematology Yancheng 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