摘要
目的探讨治疗前血清乳酸脱氢酶/白蛋白比值(LAR)与根治性放疗后鼻咽癌长期生存的关系。方法收集2007年10月至2009年12月之间初治的956例接受根治性放疗的鼻咽癌患者为研究对象,应用单因素和多因素分析的统计学方法分析LAR与鼻咽癌患者总生存(OS)和无远处转移生存(DMFS)的相关性。结果根据界限值在线工具,LAR用于DMFS风险分层的最佳界值为0.385。单因素生存分析发现高LAR组的OS和DMFS均显著低于低LAR组(P<0.001)。Cox多因素回归模型发现,高LAR(P<0.001)、年龄≥45岁(P<0.001)、临床分期Ⅲ～Ⅳ期(P<0.001)是鼻咽癌患者OS的独立不良预后因素。而高LAR(P<0.001)和临床分期Ⅲ～Ⅳ期(P=0.012)则为DMFS的独立不良预后因素。结论治疗前LAR是鼻咽癌独立的不良预后因素,可用于风险分层及指导辅助治疗。
Objective To investigate the association between pretreatment serum lactate dehydrogenase（LDH）to albumin ratio（LAR）and the long-term survival of nasopharyngeal carcinoma patients after definiteradiotherapy. Methods A total of 956 treatment-naive nasopharyngeal carcinoma patients receiving definite radio-therapy between October 2007 and December 2009 were collected. Univariate and multivariate model were used toanalyze the association between pretreatment LAR and overall survival（OS）or distant-metastasis-free survival（DMFS）. Results Based on-line cutoff finder,the optimal cut-off value of LAR was determined to be 0.385. Uni-variate analysis reveals that OS and DMFS were all significantly poorer in the high LAR group than that in the lowLAR group（P〈0.001）. Cox multivariate regression model shows that high LAR（P〈0.001）,age ≥ 45 years（P〈0.001）and stage Ⅲ～Ⅳ（P〈0.001）were independent inferior prognostic factors for OS,while high CAR（P〈0.001）and stage Ⅲ～Ⅳ（P = 0.012）were independent inferior prognostic factor for DMFS. Conclusion Pretreatment LAR is an independent prognostic factor in nasopharyngeal carcinoma and could be used in risk strati-fication and guiding adjuvant therapy.
作者
郑隽
徐夏
付晓燕
ZHENG Jun;XU Xia;FU Xiaoyan.(Guangzhou General Hospital of PLA, Guang- zhou 510010, China)
出处
《实用医学杂志》
CAS
北大核心
2018年第8期1285-1288,共4页
The Journal of Practical Medicine
基金
广东省自然科学基金资助项目(编号:2014A030310032)
关键词
鼻咽癌
预后
乳酸脱氢酶
白蛋白
nasopharyngeal carcinoma
prognosis
lactate dehydrogenase
albumin
