Cetinayak Hasan Oguz, Aydin Barbaros, Semiz Volkan, Atac Kutlu Ece, Basan Umut, Aksoy Rahmi Atıl
Department of Radiation Oncology, Faculty of Medicine, Dokuz Eylul University, Izmir 35210, Türkiye.
Department of Radiation Oncology, Izmir City Hospital, Izmir 35530, Türkiye.
Diagnostics (Basel). 2025 Sep 3;15(17):2237. doi: 10.3390/diagnostics15172237.
The hypopharyngeal region is among the most aggressive sites of head and neck squamous cell carcinoma, often presenting at an advanced stage with poor survival outcomes. However, there are only a limited number of biomarkers available to predict the prognosis of this aggressive disease. Recent interest has focused on immunonutritional biomarkers that may improve prognostication. The C-reactive protein-albumin-lymphocyte (CALLY) index has emerged as a composite biomarker integrating systemic inflammation, nutritional status, and immune competence. However, its clinical relevance in hypopharyngeal cancer has not been established. This retrospective, single-center study included patients with histologically confirmed hypopharyngeal squamous cell carcinoma treated with definitive chemoradiotherapy between 2010 and 2024. Patients were excluded from the study if they had incomplete laboratory data, had a concomitant malignancy, were undergoing induction chemotherapy, or had diseases affecting inflammatory and immunological markers. The CALLY index was calculated using pre-treatment laboratory values. Receiver operating characteristic (ROC) analysis determined the optimal cut-off value for overall survival (OS). Kaplan-Meier survival estimates and Cox regression analyses were used to assess associations between the CALLY index and progression-free survival (PFS), local recurrence-free survival (LRFS), and OS. A total of 71 patients were included. The optimal CALLY cut-off was 1.47 (AUC = 0.70, = 0.006). Patients with a CALLY index ≥ 1.47 had significantly improved median PFS (37 vs. 9 months, = 0.003), LRFS (39 vs. 9 months, = 0.002), and OS (61 vs. 11 months, = 0.002). In multivariate analysis, the CALLY index and T stage remained independent prognostic factors of all three survival outcomes. The pretreatment CALLY index is a practical, accessible biomarker that independently predicts survival in hypopharyngeal cancer. Its integration into clinical practice may enhance risk stratification and guide individualized management strategies.
下咽区是头颈部鳞状细胞癌最具侵袭性的部位之一，常处于晚期，生存预后较差。然而，目前可用于预测这种侵袭性疾病预后的生物标志物数量有限。最近的研究兴趣集中在可能改善预后的免疫营养生物标志物上。C反应蛋白-白蛋白-淋巴细胞（CALLY）指数已成为一种综合生物标志物，整合了全身炎症、营养状况和免疫能力。然而，其在下咽癌中的临床相关性尚未确立。这项回顾性单中心研究纳入了2010年至2024年间接受根治性放化疗且组织学确诊为下咽鳞状细胞癌的患者。如果患者实验室数据不完整、患有合并恶性肿瘤、正在接受诱导化疗或患有影响炎症和免疫标志物的疾病，则被排除在研究之外。CALLY指数使用治疗前实验室值计算。受试者工作特征（ROC）分析确定了总生存期（OS）的最佳临界值。采用Kaplan-Meier生存估计和Cox回归分析来评估CALLY指数与无进展生存期（PFS）、无局部复发生存期（LRFS）和OS之间的关联。共纳入71例患者。CALLY的最佳临界值为1.47（AUC = 0.70，P = 0.006）。CALLY指数≥1.47的患者中位PFS（37个月对9个月，P = 0.003）、LRFS（39个月对9个月，P = 0.002）和OS（61个月对11个月，P = 0.002）均显著改善。在多变量分析中，CALLY指数和T分期仍然是所有三种生存结局的独立预后因素。治疗前CALLY指数是一种实用、可获取的生物标志物，可独立预测下咽癌的生存情况。将其纳入临床实践可能会加强风险分层并指导个体化管理策略。
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