Lien Ching-Feng, Yeh Shyh-An, Cheng Chiu-Shih, Chiang Feng-Yu, Hwang Tzer-Zen, Cai Bi-He, Liu Chih-Yi, Weng Hsu-Huei, Chen Chia-Chi, Hsieh Meng-Che
Department of Otolaryngology-Head and Neck Surgery, E-Da Hospital, I-Shou University, Kaohsiung 82445, Taiwan.
School of Medicine, College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan.
Cancers (Basel). 2025 Feb 1;17(3):488. doi: 10.3390/cancers17030488.
The prognostic impact of internal carotid artery (ICA) invasion in nasopharyngeal cancer (NPC) patients is not well established. Thus, we conducted a retrospective study to analyze the prognostic factors for ICA invasion by NPC.
This retrospective study included consecutive biopsy-proven NPC patients who received CCRT from November 2015 to December 2022 at E-Da Hospital. Patients were then classified into two groups according to ICA invasion by tumor or not. Survival was estimated by the Kaplan-Meier method with a five-year overall survival (OS) rate and five-year disease specific survival (DSS) rate.
A total of 191 patients with pathologically confirmed NPC were included in this study, with 54 patients in the ICA invasion group and 137 patients in the no ICA invasion group. The ICA invasion group showed a worse prognosis compared to the no ICA invasion group ( < 0.001 in OS and DSS). Patients were stratified into a poor response group and good response group. OS and DSS in the poor response group had a significant difference compared to the good response group (both < 0.001). In multivariate analysis, NLR was an independently prognostic factor for OS (HR 2.430, 95% CI 1.040-5.678, = 0.040 and HR 0.412, 95% CI 0.176-0.962, = 0.040, respectively) and for DSS (HR 2.430, 95% CI 1.040-5.678, = 0.040 and HR 0.412, 95% CI 0.176-0.962, = 0.040, respectively).
Locally advanced NPC patients with ICA invasion have a miserable outcome and NLR represents a significant prognostic factor that impacts treatment decisions and survival.
鼻咽癌（NPC）患者颈内动脉（ICA）受侵对预后的影响尚未明确。因此，我们进行了一项回顾性研究，以分析NPC侵犯ICA的预后因素。
这项回顾性研究纳入了2015年11月至2022年12月在台大医院接受同步放化疗的经活检证实的连续NPC患者。然后根据肿瘤是否侵犯ICA将患者分为两组。采用Kaplan-Meier法估计生存率，计算五年总生存率（OS）和五年疾病特异性生存率（DSS）。
本研究共纳入191例经病理证实的NPC患者，其中ICA侵犯组54例，无ICA侵犯组137例。与无ICA侵犯组相比，ICA侵犯组预后较差（OS和DSS均P<0.001）。将患者分为反应差组和反应好组。反应差组的OS和DSS与反应好组相比有显著差异（均P<0.001）。多因素分析显示，中性粒细胞与淋巴细胞比值（NLR）是OS（HR 2.430，95%CI 1.040 - 5.678，P = 0.040；HR 0.412，95%CI 0.176 - 0.962，P = 0.040）和DSS（HR 2.430，95%CI 1.040 - 5.678，P = 0.040；HR 0.412，95%CI 0.176 - 0.962，P = 0.040）的独立预后因素。
局部晚期ICA受侵的NPC患者预后较差，NLR是影响治疗决策和生存的重要预后因素。
