State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, 510060, People's Republic of China.
Department of Breast Oncology, Sun Yat-sen University Cancer Center, Guangzhou, 510060, People's Republic of China.
BMC Cancer. 2024 Aug 15;24(1):1012. doi: 10.1186/s12885-024-12763-z.
Recently, the hemoglobin to albumin ratio (HAR) has been shown to be closely associated with the survival of certain malignancies. However, its prognostic value in nasopharyngeal carcinoma (NPC) remained to be elucidated. Herein, we aimed to explore the correlation between HAR and overall survival (OS) in NPC patients treated with concurrent chemoradiotherapy (CCRT).
This retrospective study included a total of 858 patients with NPC receiving CCRT between January 2010 and December 2014 in Sun Yat-sen University Cancer Center. We randomly divided them into the training cohort (N = 602) and the validation cohort (N = 206). We performed univariate and multivariate Cox regression analyses to identify variables associated with OS, based on which, a predictive nomogram was constructed and assessed.
In both the training and validation cohorts, patients were classified into low- and high-HAR groups according to the cutoff value determined by the maximally selected rank statistics. This HAR cutoff value effectively divided patients into two distinct prognostic groups with significant differences. Multivariable Cox analysis revealed that higher T-stage, N-stage, and HAR values were significantly related to poorer prognosis in NPC patients and served as independent prognostic factors for NPC. Based on these, a predictive model was constructed and graphically presented as a nomogram, whose predictive performance is satisfactory with a C-index of 0.744 [95%CI: 0.679-0.809] and superior to traditional TNM staging system [C-index = 0.609, 95%CI: 0.448-0.770].
The HAR value was an independent predictor for NPC patients treated with CCRT, the predictive model based on HAR with superior predictive performance than traditional TNM staging system might improve individualized survival predictions.
最近，血红蛋白与白蛋白比值（HAR）已被证明与某些恶性肿瘤的生存密切相关。然而，其在鼻咽癌（NPC）中的预后价值仍有待阐明。在此，我们旨在探讨接受同期放化疗（CCRT）治疗的 NPC 患者中 HAR 与总生存期（OS）之间的相关性。
本回顾性研究纳入了中山大学肿瘤防治中心 2010 年 1 月至 2014 年 12 月期间接受 CCRT 的共 858 例 NPC 患者。我们将其随机分为训练队列（N=602）和验证队列（N=206）。我们进行单变量和多变量 Cox 回归分析，以确定与 OS 相关的变量，并基于这些变量构建并评估预测列线图。
在训练和验证队列中，根据最大选择秩统计确定的截止值，患者被分为低和高 HAR 组。该 HAR 截止值有效地将患者分为两个具有显著差异的预后组。多变量 Cox 分析显示，较高的 T 分期、N 分期和 HAR 值与 NPC 患者的预后较差显著相关，是 NPC 的独立预后因素。基于这些因素，构建了一个预测模型，并以列线图的形式呈现，其预测性能令人满意，C 指数为 0.744[95%CI：0.679-0.809]，优于传统的 TNM 分期系统[C 指数=0.609，95%CI：0.448-0.770]。
HAR 值是接受 CCRT 治疗的 NPC 患者的独立预测因子，基于 HAR 的预测模型具有优于传统 TNM 分期系统的预测性能，可能改善个体化生存预测。
