Takenaka Yukinori, Oya Ryohei, Aoki Kengo, Hamaguchi Hiroko, Takemura Kazuya, Nozawa Masayuki, Kitamura Takahiro, Yamamoto Yoshifumi, Uno Atsuhiko
a Department of Otorhinolaryngology-Head and Neck Surgery , Osaka General Medical Center , Osaka , Japan.
Acta Otolaryngol. 2018 Apr;138(4):433-436. doi: 10.1080/00016489.2017.1398839. Epub 2017 Dec 12.
To examine whether lactate dehydrogenase (LDH) can predict the prognosis of oral cavity squamous cell carcinoma (OSCC) and to determine the optimal cut-off values for LDH.
This retrospective study included 184 patients with OSCC, treated with surgery between 2006 and 2014. The association between LDH and T, N classification was investigated using the Mann-Whitney test. Cut-off values for LDH were determined with a recursive partitioning analysis (RPA). Survival rates were estimated using the Kaplan-Meier method. A Cox hazard model was used to assess the prognostic capability of LDH.
There was no association between LDH and T or N classification (p = .657, .619, respectively). RPA determined the cut-off values for LDH as 160 and 220 IU/L. The five year survival for low-, moderate-, and high-LDH groups were 87.7, 73.7, and 50.9%, respectively (p < .001). The hazard ratios (HRs) for death in moderate- and high-LDH groups were 2.92 (95%CI =1.02-12.30, p = .001) and 7.36 (95%CI =2.54-31.20, p < .001), respectively. The model including LDH-based stratification (Akaike's information criterion (AIC) = 516) was better than the model including clinical stage (AIC =528).
Pretreatment serum LDH is an independent prognostic factor for overall survival in patients with OSCC.
探讨乳酸脱氢酶(LDH)能否预测口腔鳞状细胞癌(OSCC)的预后,并确定LDH的最佳临界值。
这项回顾性研究纳入了2006年至2014年间接受手术治疗的184例OSCC患者。采用Mann-Whitney检验研究LDH与T、N分期之间的关联。通过递归划分分析(RPA)确定LDH的临界值。采用Kaplan-Meier法估计生存率。使用Cox风险模型评估LDH的预后能力。
LDH与T分期或N分期之间无关联(p分别为0.657和0.619)。RPA确定LDH的临界值为160和220 IU/L。低、中、高LDH组的五年生存率分别为87.7%、73.7%和50.9%(p<0.001)。中、高LDH组的死亡风险比(HR)分别为2.92(95%CI=1.02-12.30,p=0.001)和7.36(95%CI=2.54-31.20,p<0.001)。包含基于LDH分层的模型(赤池信息准则(AIC)=516)优于包含临床分期的模型(AIC=528)。
治疗前血清LDH是OSCC患者总生存的独立预后因素。