Liang Tianhao, Liu Weixing, Xie Junyang, Wang Yiyan, Chen Gui, Liao Wenjing, Song Lijuan, Zhang Xiaowen
State Key Laboratory of Respiratory Disease, Department of Otolaryngology-Head and Neck Surgery, First Affiliated Hospital, Guangzhou Medical University, #151 Yanjiang Road, Guangzhou, 510120, Guangdong, People's Republic of China.
Cancer Cell Int. 2021 Jun 30;21(1):329. doi: 10.1186/s12935-021-02035-2.
Patients with nasopharyngeal cancer (NPC) differ in prognosis, even at the same stage; therefore, new biomarkers are urgently required to identify early-stage NPC patients at high risk of poor prognosis. Although Epstein-Barr virus (EBV) DNA has been used for prognosis, the value of many other biomarkers expressed during the infection cycle of EBV remains unclarified. This study aimed to evaluate the prognostic potential of EA-IgA, VCA-IgA and D-dimer in patients with NPC.
Electronic databases, including PubMed, Embase and Web of Science, were searched up to February 1, 2021. Pooled data were extracted from studies that evaluated the relationship between NPC and overall survival (OS), distant metastasis-free survival (DMFS) or disease-free survival (DFS) and then were subjected to a meta-analysis.
Nine studies with 5729 patients were included in this meta-analysis. In patients with NPC, EA-IgA levels significantly predicted OS (HR = 1.63, 95% CI 1.07-2.48). D-Dimer levels significantly predicted OS (HR = 1.75, 95% CI 1.24-2.47) and DMFS (HR = 1.91, 95% CI 1.31-2.79). However, high levels of VCA-IgA were not associated with OS (HR = 1.24, 95% CI 0.95-1.60), DMFS (HR = 1.41, 95% CI 0.92-2.17) or DFS (HR = 2.39, 95% CI 0.78-7.26).
The present findings reveal that EA-IgA and D-dimer, but not VCA-IgA, can be used as prognostic biomarkers in NPC.
鼻咽癌（NPC）患者即使处于同一阶段，预后也存在差异；因此，迫切需要新的生物标志物来识别预后不良风险高的早期NPC患者。尽管爱泼斯坦-巴尔病毒（EBV）DNA已用于预后评估，但在EBV感染周期中表达的许多其他生物标志物的价值仍不明确。本研究旨在评估EA-IgA、VCA-IgA和D-二聚体在NPC患者中的预后潜力。
检索截至2021年2月1日的电子数据库，包括PubMed、Embase和Web of Science。从评估NPC与总生存期（OS）、无远处转移生存期（DMFS）或无病生存期（DFS）之间关系的研究中提取汇总数据，然后进行荟萃分析。
本荟萃分析纳入了9项研究，共5729例患者。在NPC患者中，EA-IgA水平显著预测OS（HR = 1.63，95%CI 1.07 - 2.48）。D-二聚体水平显著预测OS（HR = 1.75，95%CI 1.24 - 2.47）和DMFS（HR = 1.91，95%CI 1.31 - 2.79）。然而，高水平的VCA-IgA与OS（HR = 1.24，95%CI 0.95 - 1.60）、DMFS（HR = 1.41，95%CI 0.92 - 2.17）或DFS（HR = 2.39，95%CI 0.78 - 7.26）无关。
目前的研究结果表明，EA-IgA和D-二聚体而非VCA-IgA可作为NPC的预后生物标志物。
