1. A Novel Inflammation-Based Stage (I Stage) Predicts Overall Survival of Patients with Nasopharyngeal Carcinoma.
- Author
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Li JP, Chen SL, Liu XM, He X, Xing S, Liu YJ, Lin YH, and Liu WL
- Subjects
- Adult, Aged, Area Under Curve, Biomarkers blood, Carcinoma, Cell Count, Female, Glasgow Outcome Scale, Humans, Inflammation, Male, Middle Aged, Multivariate Analysis, Nasopharyngeal Carcinoma, Nasopharyngeal Neoplasms blood, Nasopharyngeal Neoplasms pathology, Neoplasm Staging, Prognosis, ROC Curve, Retrospective Studies, Risk Factors, Survival Analysis, Blood Platelets pathology, C-Reactive Protein metabolism, Nasopharyngeal Neoplasms diagnosis, Nasopharyngeal Neoplasms mortality, Neutrophils pathology, Serum Albumin metabolism
- Abstract
Recent studies have indicated that inflammation-based prognostic scores, such as the Glasgow Prognostic Score (GPS), modified GPS (mGPS) and C-reactive protein/Albumin (CRP/Alb) ratio, platelet-lymphocyte ratio (PLR), and neutrophil-lymphocyte ratio (NLR), have been reported to have prognostic value in patients with many types of cancer, including nasopharyngeal carcinoma (NPC). In this study, we proposed a novel inflammation-based stage, named I stage, for patients with NPC. A retrospective study of 409 newly-diagnosed cases of NPC was conducted. The prognostic factors (GPS, mGPS, CRP/Alb ratios, PLR, and NLR) were evaluated using univariate and multivariate analyses. Then, according to the results of the multivariate analyses, we proposed a I stage combination of independent risk factors (CRP/Alb ratio and PLR). The I stage was calculated as follows: patients with high levels of CRP/Alb ratio (>0.03) and PLR (>146.2) were defined as I2; patients with one or no abnormal values were defined as I1 or I0, respectively. The relationships between the I stage and clinicopathological variables and overall survival (OS) were evaluated. In addition, the discriminatory ability of the I stage with other inflammation-based prognostic scores was assessed using the AUCs (areas under the curves) analyzed by receiver operating characteristics (ROC) curves. The p value of <0.05 was considered to be significant. A total of 409 patients with NPC were enrolled in this study. Multivariate analyses revealed that only the CRP/Alb ratio (Hazard ratio (HR) = 2.093; 95% Confidence interval (CI): 1.222-3.587; p = 0.007) and PLR (HR: 2.003; 95% CI: 1.177-3.410; p = 0.010) were independent prognostic factors in patients with NPC. The five-year overall survival rates for patients with I0, I1, and I2 were 92.1% ± 2.9%, 83.3% ± 2.6%, and 63.1% ± 4.6%, respectively ( p < 0.001). The I stage had a higher area under the curve value (0.670) compared with other systemic inflammation-based prognostic scores ( p < 0.001). The I stage is a novel and useful predictive factor for OS in patients with NPC., Competing Interests: The authors declare no conflicts of interest. Informed consent was obtained from all individual participants included in the study.
- Published
- 2016
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