High pretreatment serum lactate dehydrogenase level correlates with disease relapse and predicts an inferior outcome in locally advanced nasopharyngeal carcinoma
High pretreatment serum lactate dehydrogenase level correlates with disease relapse and predicts an inferior outcome in locally advanced nasopharyngeal carcinoma
复制标题
治疗前高血清乳酸脱氢酶水平与疾病复发相关，并预测局部晚期鼻咽癌的较差预后
DOI：
10.1016/j.ejca.2013.03.008
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发表时间：
2013-07-01
影响因子：
8.4
通讯作者：
Hong, Ming-huang
中科院分区：
文献类型：
--
作者：
Wan, Xiang-bo;Wei, Li;Hong, Ming-huang
目的：为探讨局部晚期鼻咽癌（NPC）患者术前血清乳酸脱氢酶（LDH）水平对预后的影响，采用随机对照研究方法，对199例接受新辅助放化疗和201例接受新辅助放化疗的局部晚期NPC患者术前血清LDH水平进行检测。结果：367例（91.75%）患者治疗前血清LDH水平正常（109.0- 245.0U/L），33例（8.25%）患者治疗前血清LDH水平升高（>= 245.0U/L）。这400例患者的平均和中位治疗前LDH水平分别为186.6和174.0 U/L（范围：83.0-751.0 U/L）。与正常亚组相比，LDH水平升高预测5年总生存率较低（56.9% vs 76.8%，P = 0.004），无病生存期（DFS，45.4% vs 64.7%，P = 0.001），局部无复发生存率（76.1%对89.6%，P = 0.019）和无远处转移生存率（DMFS，54.3%对72.2%，P = 0.001）。多因素分析证实LDH水平是预测死亡、疾病进展、局部复发和远处转移的独立预后因素。对于LDH正常的亚组（中位数为177.0 U/L），我们检测到明显的5年DFS（68.8% vs 59.5%，P = 0.047）和DMFS优势血清LDH水平在109.0-177.0 U/L亚组的阳性率为77.3%vs65.3%，P = 0.016。结论：血清LDH水平是局部晚期鼻咽癌的独立预后因素。将术前LDH与TNM分期相结合可能会导致更准确的风险定义。(c)2013爱思唯尔有限公司保留所有权利。
Purpose: Here, we evaluate the prognostic effect of pretreatment serum lactate dehydrogenase (LDH) in locally advanced nasopharyngeal carcinoma (NPC).Methods and materials: Pretreatment serum samples from a randomized controlled trial, which contained 199 neoadjuvant chemoradiotherapy patients and 201 neoadjuvant-concurrent chemoradiotherapy cases with locally advanced NPC, were collected and examined for LDH. With 5-year follow-up, the prognostic effect of pretreatment serum LDH was analysed by Kaplan-Meier analysis and multivariate Cox regression model.Results: Three hundred and sixty-seven patients (91.75%) had a normal (109.0-245.0 U/L) pretreatment LDH level, compared to 33 cases (8.25%) that had a higher (>= 245.0 U/L) LDH level. The mean and median pretreatment LDH levels of these 400 patients were 186.6 and 174.0 U/L (range, 83.0-751.0 U/L), respectively. Compared with the normal subset, elevated LDH level predicted an inferior 5-year overall survival (56.9% versus 76.8%, P = 0.004), disease-free survival (DFS, 45.4% versus 64.7%, P = 0.001), local relapse-free survival (76.1% versus 89.6%, P = 0.019) and distant metastasis-free survival (DMFS, 54.3% versus 72.2%, P = 0.001). Multivariate analysis confirmed that the LDH level was an independent prognostic factor to predict death, disease progression, local relapse and distant metastasis. For the subgroup with normal LDH (median point of 177.0 U/L), we detected an evident 5-year DFS (68.8% versus 59.5%, P = 0.047) and DMFS advantage (77.3% versus 65.3%, P = 0.016) in 109.0-177.0 U/L subset than that of 178.0-245.0 U/L subgroup.Conclusions: Serological LDH level was an independent prognostic factor for locally advanced NPC. Combining pretreatment LDH with TNM staging might lead to more accurate risk definition. (c) 2013 Elsevier Ltd. All rights reserved.