A Novel Inflammation-Based Stage (I Stage) Predicts Overall Survival of Patients with Nasopharyngeal Carcinoma.
A Novel Inflammation-Based Stage (I Stage) Predicts Overall Survival of Patients with Nasopharyngeal Carcinoma.
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一种新的基于炎症的分期（I 期）可预测鼻咽癌患者的总体生存期。
DOI：
10.3390/ijms17111900
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发表时间：
2016-11-15
影响因子：
5.6
通讯作者：
Liu WL
中科院分区：
文献类型：
--
作者：
Li JP;Chen SL;Liu XM;He X;Xing S;Liu YJ;Lin YH;Liu WL
最近的研究表明，基于炎症的预后评分，如格拉斯哥预后评分（GPS）、改良GPS （mGPS）和c反应蛋白/白蛋白（CRP/Alb）比值、血小板-淋巴细胞比值（PLR）和中性粒细胞-淋巴细胞比值（NLR），已被报道对包括鼻咽癌（NPC）在内的许多类型的癌症患者具有预后价值。在这项研究中，我们提出了一个新的基于炎症的鼻咽癌分期，命名为I期。对409例新诊断的鼻咽癌进行回顾性研究。采用单因素和多因素分析评估预后因素（GPS、mGPS、CRP/Alb比值、PLR和NLR）。然后，根据多因素分析结果，我们提出了独立危险因素（CRP/Alb比率和PLR）的I期组合。I期计算如下：将CRP/Alb比值（> = 0.03）和PLR（> = 146.2）水平较高的患者定义为I2期；有一个或没有异常值的患者分别定义为I1或I0。评估I期与临床病理变量及总生存期（OS）的关系。此外，使用受试者工作特征（ROC）曲线分析的auc（曲线下面积）来评估I期与其他基于炎症的预后评分的区分能力。p值<0.05为显著性。本研究共纳入409例NPC患者。多因素分析显示，只有CRP/Alb比值(危险比(HR) = 2.093；95%置信区间（CI）： 1.222-3.587；p = 0.007)和PLR （HR: 2.003; 95% CI: 1.177 ~ 3.410; p = 0.010）是鼻咽癌患者的独立预后因素。I0、I1、I2患者的5年总生存率分别为92.1%±2.9%、83.3%±2.6%、63.1%±4.6% （p < 0.001）。与其他系统性炎症预后评分相比，I期曲线下面积（0.670）更高（p < 0.001）。I期是鼻咽癌患者发生OS的一个新颖而有用的预测因素。
Recent studies have indicated that inflammation-based prognostic scores, such as the Glasgow Prognostic Score (GPS), modified GPS (mGPS) and C-reactive protein/Albumin (CRP/Alb) ratio, platelet–lymphocyte ratio (PLR), and neutrophil–lymphocyte ratio (NLR), have been reported to have prognostic value in patients with many types of cancer, including nasopharyngeal carcinoma (NPC). In this study, we proposed a novel inflammation-based stage, named I stage, for patients with NPC. A retrospective study of 409 newly-diagnosed cases of NPC was conducted. The prognostic factors (GPS, mGPS, CRP/Alb ratios, PLR, and NLR) were evaluated using univariate and multivariate analyses. Then, according to the results of the multivariate analyses, we proposed a I stage combination of independent risk factors (CRP/Alb ratio and PLR). The I stage was calculated as follows: patients with high levels of CRP/Alb ratio (>0.03) and PLR (>146.2) were defined as I2; patients with one or no abnormal values were defined as I1 or I0, respectively. The relationships between the I stage and clinicopathological variables and overall survival (OS) were evaluated. In addition, the discriminatory ability of the I stage with other inflammation-based prognostic scores was assessed using the AUCs (areas under the curves) analyzed by receiver operating characteristics (ROC) curves. The p value of <0.05 was considered to be significant. A total of 409 patients with NPC were enrolled in this study. Multivariate analyses revealed that only the CRP/Alb ratio (Hazard ratio (HR) = 2.093; 95% Confidence interval (CI): 1.222–3.587; p = 0.007) and PLR (HR: 2.003; 95% CI: 1.177–3.410; p = 0.010) were independent prognostic factors in patients with NPC. The five-year overall survival rates for patients with I0, I1, and I2 were 92.1% ± 2.9%, 83.3% ± 2.6%, and 63.1% ± 4.6%, respectively (p < 0.001). The I stage had a higher area under the curve value (0.670) compared with other systemic inflammation-based prognostic scores (p < 0.001). The I stage is a novel and useful predictive factor for OS in patients with NPC.
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