Li Xiaohui, Chang Hui, Tao Yalan, Wang Xiaohui, Gao Jin, Zhang Wenwen, Chen Chen, Xia Yunfei
Department of Radiation Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center of Cancer Medicine, Guangzhou 510060, China; Department of Oncology, the 421 Hospital of Chinese People's Liberation Army, Guangzhou 510318, China.
Department of Radiation Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center of Cancer Medicine, Guangzhou 510060, China.
Chin J Cancer Res. 2016 Oct;28(5):467-477. doi: 10.21147/j.issn.1000-9604.2016.05.01.
In our previous work, we incorporated complete blood count (CBC) into TNM stage to develop a new prognostic score model, which was validated to improve prediction efficiency of TNM stage for nasopharyngeal carcinoma (NPC). The purpose of this study was to revalidate the accuracy of the model, and its superiority to TNM stage, through data from a prospective study.
CBC of 249 eligible patients from the 863 Program No. 2006AA02Z4B4 was evaluated. Prognostic index (PI) of each patient was calculated according to the score model. Then they were divided by the PI into three categories: the low-, intermediate-and high-risk patients. The 5-year disease-specific survival (DSS) of the three categories was compared by a log-rank test. The model and TNM stage (7th edition) were compared on efficiency for predicting the 5-year DSS, through comparison of the area under curve (AUC) of their receiver-operating characteristic curves.
The 5-year DSS of the low-, intermediate-and high-risk patients were 96.0%, 79.1% and 62.2%, respectively. The low-and intermediate-risk patients had better DSS than the high-risk patients (P<0.001 and P<0.005, respectively). And there was a trend of better DSS in the low-risk patients, compared with the intermediate-risk patients (P=0.049). The AUC of the model was larger than that of TNM stage (0.726 . 0.661, P=0.023).
A CBC-based prognostic score model was revalidated to be accurate and superior to TNM stage on predicting 5-year DSS of NPC.
在我们之前的研究中，我们将全血细胞计数（CBC）纳入TNM分期，以建立一个新的预后评分模型，该模型经验证可提高TNM分期对鼻咽癌（NPC）的预测效率。本研究的目的是通过一项前瞻性研究的数据，重新验证该模型的准确性及其相对于TNM分期的优越性。
对863计划项目2006AA02Z4B4中249例符合条件患者的CBC进行评估。根据评分模型计算每位患者的预后指数（PI）。然后根据PI将患者分为三类：低危、中危和高危患者。通过对数秩检验比较这三类患者的5年疾病特异性生存率（DSS）。通过比较模型和TNM分期（第7版）的受试者操作特征曲线下面积（AUC），比较二者预测5年DSS的效率。
低危、中危和高危患者的5年DSS分别为96.0%、79.1%和62.2%。低危和中危患者的DSS均优于高危患者（分别为P<0.001和P<0.005）。并且，与中危患者相比，低危患者的DSS有更好的趋势（P=0.049）。模型的AUC大于TNM分期（0.726对0.661，P=0.023）。
基于CBC的预后评分模型经重新验证，在预测NPC的5年DSS方面准确且优于TNM分期。
