Diagnostic and prognostic value of coagulation markers and platelet-derived growth factor-BB in evaluating intensity-modulated radiotherapy efficacy in nasopharyngeal carcinoma.

OBJECTIVES

To evaluate the diagnostic and prognostic value of coagulation markers - including activated partial thromboplastin time (APTT), prothrombin time (PT), fibrinogen (FIB), platelet count (PLT), and D-dimer (DD) - and platelet-derived growth factor-BB (PDGF-BB) in patients with nasopharyngeal carcinoma (NPC) undergoing intensity-modulated radiotherapy (IMRT).

METHODS

A total of 210 NPC patients receiving IMRT and 160 healthy controls were enrolled. Baseline levels of PDGF-BB and coagulation markers were compared between groups. The association of PDGF-BB with clinical staging was analyzed, and receiver operating characteristic (ROC) curve analysis was used to assess its diagnostic performance. Cox regression analyses were performed to identify independent predictors of five-year survival. A dynamic nomogram was developed to provide individualized survival predictions.

RESULTS

NPC patients exhibited significantly higher levels of PDGF-BB, APTT, PT, FIB, PLT, and DD compared to healthy controls (all P < 0.001). PDGF-BB was positively correlated with TNM stage (stage III/IV vs. I/II, P < 0.001), T stage (P = 0.005), and N stage (P = 0.020). Multivariate Cox regression identified low PDGF-BB (< 628.18) (HR = 0.492, P = 0.009), low DD (< 746.1) (HR = 0.456, P = 0.002), age 51-64 years (HR = 2.057, P = 0.032) and ≥ 65 years (HR = 4.138, P < 0.001), EBV DNA negativity (HR = 0.273, P = 0.012), and TNM stage III/IV (HR = 3.042, P = 0.023) as independent prognostic factors.

CONCLUSIONS

PDGF-BB and DD, alongside age, EBV DNA status, and TNM stage, are promising biomarkers for NPC prognosis. A dynamic nomogram integrating these factors offers accurate survival prediction and supports personalized treatment strategies in NPC management.