The effects of hemoglobin levels and their interactions with cigarette smoking on survival in nasopharyngeal carcinoma patients.
The effects of hemoglobin levels and their interactions with cigarette smoking on survival in nasopharyngeal carcinoma patients.
复制标题
血红蛋白水平及其与吸烟的相互作用对鼻咽癌患者生存的影响
作者：
Zeng Q;Shen LJ;Li S;Chen L;Guo X;Qian CN;Wu PH
关于血红蛋白（Hb）水平与吸烟联合对鼻咽癌（NPC）患者生存的预后价值的已发表信息很少，它们之间的相互作用仍不清楚。共有2440例鼻咽癌患者被证实，并进行多变量分析，以确定有价值的预后血红蛋白水平在整个人口和吸烟者的队列。使用对数秩检验比较生存差异。使用考克斯回归和Microsoft Word Excel电子表格评估乘法和加法相互作用。放射治疗后（RT）Hb是总生存期（OS）（HR = 0.797; P = 0.006）、无失败生存期（FFS）（HR=0.811; P = 0.010）和局部无失败生存期（LR-FFS）（HR = 0.725; P = 0.000）的独立预后因素。在吸烟者队列中，包-年也是OS（HR = 0.673; P < 0.001）和FFS（HR = 0.681; P < 0.001）、LR-FFS（HR = 0.663; P = 0.001）的独立预测因子。发现低RT后Hb和高SI之间的相互作用对OS具有显著的正相加效应，RERI = 5.616，AP = 0.665，S = 4.078。分层分析表明，与RT后Hb水平较高的轻度吸烟者相比，RT后Hb水平较低的重度吸烟者死亡的HR为2.295（P <0.001），疾病失败的HR为2.222（P <0.001），局部复发的HR为2.267（P < 0.001），RT后Hb水平是NPC患者生存的重要预测因素。RT后Hb水平和包年之间的积极相互作用导致生存不良风险升高。肿瘤学家应特别注意在未来的RT后Hb水平低的重度吸烟者。
There is very little published information regarding the prognostic value of hemoglobin (Hb) levels combined with smoking on the survival of patients with nasopharyngeal carcinoma (NPC), and the interactions between them remain unclear. A total of 2440 NPC patients were confirmed, and multivariate analysis was performed to identify valuable prognostic Hb levels in the entire population and in the cohort of smokers. The survival differences were compared using log‐rank tests. The multiplicative and additive interactions were assessed using Cox regression and a Microsoft Word Excel spreadsheet. Postradiotherapy (RT) Hb was an independent prognostic factor for overall survival (OS) (HR = 0.797; P = 0.006), failure‐free survival (FFS) (HR=0.811; P = 0.010), and loco‐regional failure‐free survival (LR‐FFS) (HR = 0.725; P = 0.000). In the cohort of smokers, pack‐years was also an independent predictor of OS (HR = 0.673; P < 0.001) and FFS (HR = 0.681; P < 0.001), LR‐FFS (HR = 0.663; P = 0.001). A significant positive additive effect was found for the interaction between low post‐RT Hb and high SI on OS, with RERI = 5.616, AP = 0.665, and S = 4.078. Stratified analyses demonstrated that heavy smokers with low post‐RT Hb had HRs of 2.295 (P < 0.001) for death, 2.222 (P < 0.001) for disease failure, and 2.267 (P < 0.001) loco‐regional recurrence compared with light smokers with high post‐RT Hb levels, and post‐RT Hb level is an important predictor of survival in patients with NPC. The positive interaction between post‐RT Hb level and pack‐years contributes to the elevated risk of poor survival. Oncologists should devote particular attention to heavy smokers with low post‐RT Hb levels in the future.