Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.
Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, Guangzhou, China.
Cancer Res Treat. 2018 Jul;50(3):701-711. doi: 10.4143/crt.2017.180. Epub 2017 Jul 14.
The measuring Epstein-Barr virus (EBV) DNA is an important predictor of nasopharyngeal carcinoma (NPC). This study evaluated the predictive value of pretreatment serum amyloid A (SAA) and C-reactive protein (CRP) comparing with EBV DNA in patients with NPC.
In an observational study of 419 non-metastatic NPC patients, we prospectively evaluated the prognostic effects of pretreatment SAA, CRP, and EBV DNA on survival. The primary endpoint was progress-free survival (PFS).
The median level of SAA and CRP was 4.28 mg/L and 1.88 mg/L, respectively. For the highSAA group (> 4.28 mg/L) versus the low-SAA (≤ 4.28 mg/L) group and the high-CRP group (> 1.88 mg/L) versus the low-CRP (≤ 1.88 mg/L) group, the 5-year PFS was 64.5% versus 73.1% (p=0.013) and 65.2% versus 73.3% (p=0.064), respectively. EBV DNA detection showed a superior predictive result, the 5-year PFS in the EBV DNA ≥ 1,500 copies/mL group was obviously different than the EBV DNA < 1,500 copies/mL group (62.2% versus 77.8%, p < 0.001). Multifactorial Cox regression analysis confirmed that in the PFS, the independent prognostic factors were including EBV DNA (hazard ratio [HR], 1.788; p=0.009), tumour stage (HR, 1.903; p=0.021), and node stage (HR, 1.498; p=0.049), but the SAA and CRP were not included in the independent prognostic factors.
The results of SAA and CRP had a certain relationship with the prognosis of NPC, and the prognosis of patients with high level of SAA and CRP were poor. However, the predictive ability of SAA and CRP was lower than that of EBV DNA.
检测 Epstein-Barr 病毒（EBV）DNA 是预测鼻咽癌（NPC）的重要指标。本研究评估了治疗前血清淀粉样蛋白 A（SAA）和 C 反应蛋白（CRP）与 EBV DNA 相比在 NPC 患者中的预测价值。
在一项对 419 例非转移性 NPC 患者的观察性研究中，我们前瞻性评估了治疗前 SAA、CRP 和 EBV DNA 对生存的预后影响。主要终点是无进展生存期（PFS）。
SAA 和 CRP 的中位水平分别为 4.28mg/L 和 1.88mg/L。对于高 SAA 组（>4.28mg/L）与低 SAA 组（≤4.28mg/L）和高 CRP 组（>1.88mg/L）与低 CRP 组（≤1.88mg/L），5 年 PFS 分别为 64.5%和 73.1%（p=0.013）和 65.2%和 73.3%（p=0.064）。EBV DNA 检测显示出更好的预测结果，EBV DNA≥1500 拷贝/ml 组的 5 年 PFS 明显不同于 EBV DNA＜1500 拷贝/ml 组（62.2%与 77.8%，p＜0.001）。多因素 Cox 回归分析证实，在 PFS 中，独立的预后因素包括 EBV DNA（危险比[HR]，1.788；p=0.009）、肿瘤分期（HR，1.903；p=0.021）和淋巴结分期（HR，1.498；p=0.049），但 SAA 和 CRP 并未被纳入独立的预后因素。
SAA 和 CRP 的结果与 NPC 的预后有一定的关系，SAA 和 CRP 水平较高的患者预后较差。然而，SAA 和 CRP 的预测能力低于 EBV DNA。
