COX多因素分析和ROC曲线综合评价DNA修复基因对鼻咽癌的预后价值

Combinating COX multivariate analysis with ROC curve to evaluate the prognostic value of DNA repair gene in nasopharyneal carcinoma

目的应用COX多因素分析和ROC曲线探讨DNA修复基因对鼻咽癌的预后价值。方法收集2007年5月至2012年2月经广西壮族自治区人民医院病理科确诊为鼻咽癌且选择调强放射治疗的患者100例。筛选随访时间超过1年的患者共71例,用免疫组化SP法检测鼻咽癌组织中DNA修复基因DNA-PKcs及BRCA1的表达。用Spearman分析DNA-PKcs和BRCA1的表达水平与临床特征的相关性;ROC曲线法建立预后分组,用Kaplan-Meier生存曲线对DNA-PKcs、BRCA1的表达与预后关系进行单因素分析;Cox比例风险回归对预后进行多因素生存分析。结果 1)DNA-PKcs的表达水平和患者的生存时间呈正相关(P<0.05)。2)DNA-PKcs高表达患者的生存时间长于低表达的患者(P<0.01)。3)多因素生存分析,DNA-PKcs表达水平是影响预后的独立因素(P<0.01),而BRCA1表达水平未能得出类似结果。结论 DNA-PKcs表达状态是影响预后的独立因素。DNA-PKcs高表达可能作为预测鼻咽癌患者预后较好的一个指标。

Objective Using COX multivariate analysis and ROC curve to evaluate the prognostic value of DNA repair gene in patients with nasopharyngeal carcinoma.Methods From May 2007 to February 2012,all 100 untreated patients with NPC,who were planned to receive IMRT at the People＇s Hospital of Guangxi Autonomous Region were enrolled into this study.Screening for more than 1 year follow-up of 71 cases,formalin-fixed tumor biopsy specimens from 71 untreated patients with NPC were analyzed by immunohistochemical methods.Spearman＇s analysis was put into use in the correlation of DNA-PKcs and BRCA1 expression level and clinical characteristics.Kaplan-Meier survival curves analyzed the relationship between expression of DNA-PKcs and BRCA1 and prognostic groups which were established by ROC curves.And Cox proportional hazards regression multi-factor survival analysis was carried out on the prognosis at last.Results 1） There was a significant positive correlation between the expression level of DNA-PKcs and survival time of patients （P ＜ 0.05）.2） Moreover,patients with high DNA-PKcs expression survived longer than patients with low level of DNA-PKcs （P ＜ 0.01）.3） On multivariate analysis,only DNA-PKcs expression level was an independent prognostic factor（P ＜ 0.01）.No significant association was found between the level of BRCA1 expression and the clinical outcome.Conclusions DNA-PKcs expression level is an independent factor in prognostic and the patients with high level had a longer survival.