治疗前血清球蛋白升高可预测鼻咽癌的不良预后

An elevated pretreatment serum globulin level predicts a poor prognosis of nasopharyngeal carcinoma

目的探讨治疗前血清球蛋白水平对评估鼻咽癌预后的价值。方法回顾性收集2009年1月至2013年12月在南方医院初治的127例无远处转移鼻咽癌患者资料,包括治疗前血清球蛋白水平。采用ROC曲线选取血清球蛋白分界值从而将病例分成低球蛋白组和高球蛋白组,采用Kaplan-Meier和COX多因素分析的方法分析治疗前血清球蛋白水平对判断鼻咽癌预后的价值。结果 ROC曲线得出治疗前血清球蛋白的分界值为30.05 g/L。球蛋白水平与性别及N分期显著相关。Kaplan-Meier分析显示治疗前高球蛋白水平(>30.05 g/L)预示不良的无进展生存率(P=0.019),总生存率(P=0.034),及无远处转移生存率(P=0.049)。多因素分析显示治疗前血清球蛋白水平是鼻咽癌进展的独立预后因素(HR=2.344,P=0.031)。结论治疗前血清球蛋白水平对鼻咽癌的预后评估有临床价值。

Objective To investigate the value of serum globulin levels before treatment in predicting the prognosis of patients with nasopharyngeal carcinoma（NPC）. Methods A total of 127 patients with non-disseminated NPC were recruited between January, 2009 and December, 2013 at Nanfang Hospital. The pretreatment serum globulin levels were analyzed with the receiver-operating characteristic（ROC） curve analysis to select the cut-off point for low and high pretreatment serum globulin levels. Kaplan- Meier and multivariable analyses were used to evaluate the predictive value of serum globulin levels. Results The ROC curve analysis determined 30.05 g/L as the optimal cut- off value for pretreatment serum globulin level, which was significantly associated with gender（P=0.024） and N stage（P=0.016）. Kaplan-Meier analysis showed that a high pretreatment serum globulin level（〉30.05 g/L） significantly predicted poor progression- free survival（P=0.019）, overall survival（P=0.034）and distant metastasis- free survival（P=0.049）; multivariate analysis identified pretreatment serum globulin level as an independent prognostic factor for progression- free survival（HR=2.344, P=0.031）. Conclusion Pretreatment serum globulin level may serve as a valuable marker to predict the prognosis of patients with NPC.