Increased pretreatment levels of serum LDH and ALP as poor prognostic factors for nasopharyngeal carcinoma
Increased pretreatment levels of serum LDH and ALP as poor prognostic factors for nasopharyngeal carcinoma
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DOI：
10.5732/cjc.011.10283
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发表时间：
2012-04-01
影响因子：
--
通讯作者：
Xia, Yun-Fei
中科院分区：
文献类型：
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作者：
Li, Guo;Gao, Jin;Xia, Yun-Fei
在肿瘤生长中发挥潜在作用的血清酶最近被报道在多种肿瘤中具有预后相关性。然而，与鼻咽癌（NPC）预后相关的血清酶很少报道。为了明确血清酶水平是否与鼻咽癌预后相关，我们回顾了2002年5月至2003年10月中山大学肿瘤中心533例接受根治性放疗的新诊断鼻咽癌患者的乳酸脱氢酶（LDH）、碱性磷酸酶（ALP）和谷氨酰转移酶（GGT）的预处理数据。按LDH、ALP、GGT正常值上限分组。采用Kaplan-Meier法和log-rank检验从临床特征和血清酶中选择影响预后的因素，采用卡方检验分析临床特征与血清酶的关系。最后，采用Cox比例风险模型确定独立预后因素。我们发现，LDH水平升高对总生存期和无远处转移生存期的影响较差（P = 0.009和0.035），而血清ALP预处理水平升高对总生存期和局部无复发生存期的影响较差（P = 0.037和0.039）。在多变量分析中，LDH水平升高被确定为总生存的独立预后因素。因此，我们得出结论，预处理血清LDH和ALP水平升高是鼻咽癌预后不良的因素。
Serum enzymes that play potential roles in tumor growth have recently been reported to have prognostic relevance in a diverse array of tumors. However, prognosis-related serum enzymes are rarely reported for nasopharyngeal carcinoma (NPC). To clarify whether the level of serum enzymes is linked to the prognosis of NPC, we reviewed the pretreatment data of lactate dehydrogenase (LDH), alkaline phosphatase (ALP), and glutamyl transferase (GGT) in 533 newly diagnosed NPC patients who underwent radical radiotherapy between May 2002 and October 2003 at Sun Yat-sen University Cancer Center. Patients were grouped according to the upper limit of normal values of LDH, ALP, and GGT. The Kaplan-Meier method and log-rank test were used for selecting prognostic factors from clinical characteristics and serum enzymes, and the chi-square test was applied to analyze the relationships of clinical characteristics and serum enzymes. Finally, a Cox proportional hazards model was used to identify the independent prognostic factors. We found that increased levels of LDH had poor effects on both overall survival and distant metastasis-free survival (P = 0.009 and 0.035, respectively), and increased pretreatment level of serum ALP had poor effects on both overall survival and local recurrence-free survival (P = 0.037 and 0.039, respectively). In multivariate analysis, increased LDH level was identified as an independent prognostic factor for overall survival. Therefore, we conclude that increased pretreatment serum LDH and ALP levels are poor prognostic factors for NPC.