Yuan Jing, Xu Miao, Li Jing, Li Ning, Chen Li-Zhen, Feng Qi-Sheng, Zeng Yi-Xin
Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China and Collaborative Innovation Center for Cancer Medicine, Department of Experimental Research, Guangzhou, Guangdong, China.
The First Affiliated Hospital of Zhengzhou University, Department of Medical Oncology, Zhengzhou, Henan, China.
Clinics (Sao Paulo). 2016 Jul;71(6):338-43. doi: 10.6061/clinics/2016(06)09.
Patients with nasopharyngeal carcinoma experience highly variable outcomes despite receiving similar therapeutic regimens. Identifying biomarkers that predict survival and guide individualized therapy is urgently needed. Cystatin C has been explored as a valuable prognostic marker in several malignancies. We retrospectively assessed the relationship between serum cystatin C levels and nasopharyngeal carcinoma prognosis in a large cohort of nasopharyngeal carcinoma patients receiving long-term follow-up.
A total of 1063 consecutive patients diagnosed with nasopharyngeal carcinoma from June 2006 to December 2010 were retrospectively analyzed. The serum levels of cystatin C at the time of diagnosis were collected. Receiver operating characteristic curve analysis, the Kaplan-Meier method and multivariate analyses using a Cox regression model were performed to assess the correlation of cystatin C levels with overall survival, progression-free survival, distant metastasis-free survival and loco-regional recurrence-free survival.
The median follow-up duration was 68.3 months. The optimal cut-off value of cystatin C levels for predicting death was 0.945 mg/L. Compared with the low cystatin C group, the high cystatin C group experienced significantly shorter overall survival (hazard ratio=1.47, p=0.050), progression-free survival (hazard ratio=1.65, p=0.004), distant metastasis-free survival (hazard ratio=2.37, p<0.001) and loco-regional recurrence-free survival (hazard ratio=2.40, p=0.002). Based on multivariate analysis, a high cystatin C level was identified as a significant and independent negative predictor of overall survival (hazard ratio=1.47, p=0.050), progression-free survival (hazard ratio=1.65, p=0.004), distant metastasis-free survival (hazard ratio=2.37, p<0.001), and loco-regional recurrence-free survival (hazard ratio=2.40, p=0.002).
Cystatin C levels are associated with the prognosis of nasopharyngeal carcinoma patients. A high cystatin C level is an independent indicator of poor prognosis for nasopharyngeal carcinoma patients.
尽管鼻咽癌患者接受了相似的治疗方案，但其预后差异很大。因此，迫切需要确定能够预测生存并指导个体化治疗的生物标志物。胱抑素C已被研究作为多种恶性肿瘤中有价值的预后标志物。我们对一大群接受长期随访的鼻咽癌患者进行回顾性分析，以评估血清胱抑素C水平与鼻咽癌预后之间的关系。
回顾性分析2006年6月至2010年12月期间连续诊断为鼻咽癌的1063例患者。收集诊断时的血清胱抑素C水平。采用受试者工作特征曲线分析、Kaplan-Meier法以及使用Cox回归模型进行多因素分析，以评估胱抑素C水平与总生存期、无进展生存期、无远处转移生存期和无局部区域复发生存期的相关性。
中位随访时间为68.3个月。预测死亡的胱抑素C水平的最佳截断值为0.945mg/L。与低胱抑素C组相比，高胱抑素C组的总生存期（风险比=1.47，p=0.050）、无进展生存期（风险比=1.65，p=0.004）、无远处转移生存期（风险比=2.37，p<0.001）和无局部区域复发生存期（风险比=2.40，p=0.002）均显著缩短。基于多因素分析，高胱抑素C水平被确定为总生存期（风险比=1.47，p=0.050）、无进展生存期（风险比=1.65，p=0.004）、无远处转移生存期（风险比=2.37，p<—0.001）和无局部区域复发生存期（风险比=2.40，p=0.002）的显著且独立的负性预测因子。
胱抑素C水平与鼻咽癌患者的预后相关。高胱抑素C水平是鼻咽癌患者预后不良的独立指标。
