Li Guo, Gao Jin, Tao Ya-Lan, Xu Bing-Qing, Tu Zi-Wei, Liu Zhi-Gang, Zeng Mu-Sheng, Xia Yun-Fei
State Key Laboratory of Oncology in South China, Guangzhou, Guangdong 510060, PR China.
Chin J Cancer. 2012 Apr;31(4):197-206. doi: 10.5732/cjc.011.10283. Epub 2012 Jan 9.
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.
近期有报道称，在肿瘤生长过程中发挥潜在作用的血清酶与多种肿瘤的预后相关。然而，关于鼻咽癌（NPC）的预后相关血清酶却鲜有报道。为明确血清酶水平是否与NPC的预后相关，我们回顾了2002年5月至2003年10月在中山大学肿瘤防治中心接受根治性放疗的533例新诊断NPC患者的乳酸脱氢酶（LDH）、碱性磷酸酶（ALP）和谷氨酰转移酶（GGT）的治疗前数据。根据LDH、ALP和GGT的正常值上限对患者进行分组。采用Kaplan-Meier法和对数秩检验从临床特征和血清酶中筛选预后因素，并应用卡方检验分析临床特征与血清酶之间的关系。最后，使用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均有不良影响（分别为P = 0.009和0.035），血清ALP治疗前水平升高对总生存期和无局部复发生存期均有不良影响（分别为P = 0.037和0.039）。在多因素分析中，LDH水平升高被确定为总生存期的独立预后因素。因此，我们得出结论，治疗前血清LDH和ALP水平升高是NPC的不良预后因素。
