循环生物标志物评分在晚期头颈部鳞状细胞癌中的预后价值。

Prognostic value of circulating biomarker score in advanced-stage head and neck squamous cell carcinoma.

机构信息

Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.

出版信息

Eur J Cancer. 2018 Mar;92:69-76. doi: 10.1016/j.ejca.2018.01.069. Epub 2018 Feb 8.

DOI:10.1016/j.ejca.2018.01.069

PMID:29428866

Abstract

BACKGROUND

Circulating biomarker (CB) is a convenient, emerging predictive tool for treatment response and outcomes in human cancers. Therefore, we examined the prognostic value of pre-treatment and early post-treatment CBs and their summated scores in patients with head and neck squamous cell carcinoma (HNSCC).

METHODS

This study prospectively included 310 consecutive patients who underwent definitive treatment for previously untreated advanced-stage HNSCC between 2010 and 2015. The CB score was determined by complete blood counts (CBCs) and blood chemistry before and 2 months after the treatment, and the number of abnormal CB was counted from 0 to 10. Univariate and multivariate analyses with Cox proportional hazards models were used to find factors associated with disease-free survival (DFS) and overall survival (OS).

RESULTS

Most CBC profiles were significantly changed at 2-months post-treatment compared with those at pre-treatment. Univariate analyses showed that hypoalbuminemia, leucocytosis, C-reactive protein, high CB scores (≥6), age, performance status and comorbidity and tumour site were significantly associated with DFS and OS (all P < 0.05). Both pre- and post-treatment CB scores were independent factors predictive of DFS and OS outcomes in the multivariate analyses (P < 0.05). High CB scores at pre-treatment were associated with 7-10-fold increased risk of unfavourable DFS and OS outcomes, and those at 2-months post-treatment were associated with 2 to 4-fold increased risk of poor survival outcomes (all P < 0.05).

CONCLUSIONS

CB scores at pre-treatment and early post-treatment are useful for predicting survival outcomes in patients with advanced-stage HNSCC.

摘要

背景

循环生物标志物（CB）是一种方便的新兴预测工具，可用于预测人类癌症的治疗反应和结局。因此，我们研究了治疗前和治疗后早期 CB 及其总和评分在头颈部鳞状细胞癌（HNSCC）患者中的预后价值。

方法

本研究前瞻性纳入了 2010 年至 2015 年间接受过未经治疗的晚期 HNSCC 根治性治疗的 310 例连续患者。在治疗前和治疗后 2 个月，通过全血细胞计数（CBC）和血液化学检查来确定 CB 评分，并从 0 到 10 计数异常 CB 的数量。使用单因素和多因素 Cox 比例风险模型分析来寻找与无病生存（DFS）和总生存（OS）相关的因素。

结果

与治疗前相比，大多数 CBC 谱在治疗后 2 个月时明显改变。单因素分析显示，低白蛋白血症、白细胞增多、C 反应蛋白、高 CB 评分（≥6）、年龄、表现状态和合并症以及肿瘤部位与 DFS 和 OS 显著相关（均 P<0.05）。治疗前和治疗后 CB 评分均为多因素分析中预测 DFS 和 OS 结局的独立因素（P<0.05）。治疗前高 CB 评分与不利的 DFS 和 OS 结局的 7-10 倍风险相关，治疗后 2 个月的 CB 评分与不良生存结局的 2-4 倍风险相关（均 P<0.05）。