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血清乳酸脱氢酶联合多变量模型对预测初治鼻咽癌近期预后的临床意义。

Clinical significance of serum lactate dehydrogenase combined with a multivariate model for predicting the near-term outcome of primary nasopharyngeal carcinoma.

机构信息

Department of Radiotherapy, Affiliated Qingyuan Hospital, Guangzhou Medical University, Qingyuan People's Hospital.

Department of Radiotherapy, Affiliated Qingyuan Hospital, Guangzhou Medical University, Qingyuan People's Hospital.

出版信息

Life Sci. 2024 Aug 15;351:122856. doi: 10.1016/j.lfs.2024.122856. Epub 2024 Jun 17.

DOI:10.1016/j.lfs.2024.122856
PMID:38897348
Abstract

BACKGROUND AND OBJECTIVES

This investigation explores the clinical significance of integrating serum lactate dehydrogenase (LDH) with a multivariate model for assessing the short-term prognosis of primary nasopharyngeal carcinoma (NPC). Epstein-Barr virus (EBV) quantification is a crucial prognostic indicator in NPC cases, but not all patients with NPC test positive for EBV. Furthermore, widespread adoption of EBV-DNA quantification remains challenging due to its high cost. Consequently, it is imperative to incorporate additional convenient and cost-effective prognostic markers to comprehensively evaluate patient outcomes.

METHODS

This retrospective analysis included 203 newly diagnosed NPC cases treated at the Affiliated Qingyuan Hospital of Guangzhou Medical University between January 2018 and March 2022. The dataset included personal information and clinical data, and the treatment protocols followed the CSCO guidelines. Efficacy assessments were based on the RECIST 1.1 criteria and were conducted after induction chemotherapy and one week and three months after radiotherapy.

RESULTS

A noteworthy correlation emerged between baseline serum LDH levels and treatment efficacy at one week after radiotherapy (P = 0.03) and at three months after radiotherapy (P < 0.01). Additionally, a prognostic model that incorporates age (P = 0.010), LDH (P < 0.001), C-reactive protein (P = 0.010), and alkaline phosphatase (P = 0.005) demonstrated robust predictive accuracy and clinical applicability.

CONCLUSION

This investigation substantiates the significant correlation between baseline serum LDH levels and NPC outcomes. Furthermore, we introduce a refined prognostic model that holds promise for informing personalized treatment strategies, thereby contributing to the advancement of the diagnosis of NPC.

摘要

背景与目的

本研究旨在探讨血清乳酸脱氢酶(LDH)与多变量模型相结合,用于评估初诊鼻咽癌(NPC)短期预后的临床意义。EB 病毒(EBV)定量是 NPC 病例的重要预后指标,但并非所有 NPC 患者 EBV 检测均为阳性。此外,由于 EBV-DNA 定量费用较高,其广泛应用仍面临挑战。因此,有必要纳入其他方便且具有成本效益的预后标志物,以全面评估患者的预后。

方法

本回顾性分析纳入了 203 例 2018 年 1 月至 2022 年 3 月在广州医科大学附属清远医院治疗的初诊 NPC 患者。该数据集包括个人信息和临床数据,治疗方案遵循 CSCO 指南。疗效评估基于 RECIST1.1 标准,在诱导化疗后、放疗后一周和三个月进行。

结果

基线血清 LDH 水平与放疗后一周(P=0.03)和放疗后三个月(P<0.01)的治疗疗效显著相关。此外,纳入年龄(P=0.010)、LDH(P<0.001)、C 反应蛋白(P=0.010)和碱性磷酸酶(P=0.005)的预后模型具有良好的预测准确性和临床适用性。

结论

本研究证实了基线血清 LDH 水平与 NPC 结局之间存在显著相关性。此外,我们提出了一种改良的预后模型,有望为制定个体化治疗策略提供信息,从而促进 NPC 的诊断。

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