Elevated peripheral blood lymphocyte-to-monocyte ratio predicts a favorable prognosis in the patients with metastatic nasopharyngeal carcinoma / 癌症

<p><b>INTRODUCTION</b>Patients with metastatic nasopharyngeal carcinoma (NPC) have variable survival outcomes. We have previously shown that an elevated peripheral blood lymphocyte-to-monocyte ratio (LMR) is associated with an increased metastatic risk in patients with primary NPC. The present study aimed to investigate the prognostic value of pretreatment LMR in a large cohort of metastatic NPC patients.</p><p><b>METHODS</b>Clinical data of 672 patients with metastatic NPC diagnosed between January 2003 and December 2009 were analyzed. The peripheral lymphocyte and monocyte counts were retrieved, and LMR was calculated. Receiver operating characteristic (ROC) curve analysis and univariate and multivariate COX proportional hazards analyses were performed to evaluate the association of LMR with overall survival (OS).</p><p><b>RESULTS</b>Univariate analysis revealed that an elevated absolute lymphocyte count (≥1.390×10(9)/L) and LMR (≥2.475) as well as a decreased monocyte count (<0.665×10(9)/L) were significantly associated with prolonged OS. Multivariate Cox proportional hazard analysis showed that LMR (hazard ratio [HR]=0.50, 95% confidence interval [CI]=0.41-0.60, P<0.001), absolute lymphocyte count (HR=0.77, 95% CI=0.64-0.93, P=0.007), and monocyte count (HR=1.98, 95% CI=1.63-2.41, P<0.001) were independent prognostic factors. By stratification analyses, only LMR remained a significant predictor of prognosis.</p><p><b>CONCLUSION</b>We identified pretreatment LMR as an independent prognostic factor for patients with metastatic NPC. Independent validation of our findings is needed.</p>

Favorable prognosis of female patients with nasopharyngeal carcinoma / 癌症

The female sex is traditionally considered a favorable prognostic factor for nasopharyngeal carcinoma (NPC). However, no particular study has reported this phenomenon. To explore the prognostic impact of gender on patients with NPC after definitive radiotherapy, we reviewed the clinical data of 2063 consecutive patients treated between 1st January 2000 and 31st December 2003 in the Sun Yat-sen University Cancer Center. The median follow-up for the whole series was 81 months. The female and male patients with early stage disease comprised 49.4% and 28.1% of the patient population, respectively. Both the 5-year overall survival (OS) and disease-specific survival (DSS) rates of female patients were significantly higher than those of male patients (OS: 79% vs. 69%, P < 0.001; DSS: 81% vs. 70%, P < 0.001). For patients with locoregionally advanced NPC, the 5-year OS and DSS rates of female vs. male patients were 74% vs. 63% (P < 0.001) and 76% vs. 64%, respectively (P < 0.001). A multivariate analysis showed that gender, age, and TNM stage were independent prognostic factors for the 5-year OS and DSS of NPC patients. The favorable prognosis of female patients is not only attributed to the early diagnosis and treatment but might also be attributed to some intrinsic factors of female patients.

Detection of nasopharyngeal carcinoma using surface-enhanced laser desorption and ionization mass spectrometry profiles of the serum proteome / 癌症

<p><b>BACKGROUND AND OBJECTIVE</b>Early diagnosis of nasopharyngeal carcinoma (NPC) is difficult due to the insufficient specificity of the conventional examination method. This study was to investigate potential and consistent biomarkers for NPC, particularly for early detection of NPC.</p><p><b>METHODS</b>A proteomic pattern was identified in a training set (134 NPC patients and 73 control individuals) using the surface-enhanced laser desorption and ionization-mass spectrometry (SELDI-MS), and used to screen the test set (44 NPC patients and 25 control individuals) to determine the screening accuracy. To confirm the accuracy, it was used to test another group of 52 NPC patients and 32 healthy individuals at 6 months later.</p><p><b>RESULTS</b>Eight proteomic biomarkers with top-scored peak mass/charge ratios (m/z) of 8605 Da, 5320 Da, 5355 Da, 5380 Da, 5336 Da, 2791 Da, 7154 Da, and 9366 Da were selected as the potential biomarkers of NPC with a sensitivity of 90.9% (40/44) and a specificity of 92.0% (23/25). The performance was better than the current diagnostic method by using the Epstein-Barr virus (EBV) capsid antigen IgA antibodies (VCA/IgA). Similar sensitivity (88.5%) and specificity (90.6%) were achieved in another group of 84 samples.</p><p><b>CONCLUSION</b>SELDI-MS profiling might be a potential tool to identify patients with NPC, particularly at early clinical stages.</p>

Comparison of the short-term efficacy of two inductive chemotherapy regimens for locally advanced nasopharyngeal caricinoma: docetaxal plus carboplatin versus 5-fluorouracil plus carboplatin / 癌症

<p><b>BACKGROUND AND OBJECTIVE</b>The platinum-based chemotherapy combined with 5-fluorouracil (5-FU) is most frequently used for nasopharyngeal carcinoma (NPC), but the efficacy has been maintained at 50%-60%. Docetaxel is an effective drug for head and neck tumors, its administration is simple, and the administration time is short. This study was to compare the short-term efficacy and toxicity between TC regimen (inductive chemotherapy with docetaxol plus carboplatin) and FC regimen (5-FU plus carboplatin) in local advanced NPC so as to provide a new chemotherapeutic regimen for NPC.</p><p><b>METHODS</b>Fifty-eight local advanced NPC patients without previous treatment in Sun Yat-sen University Cancer Center were randomly assigned to receive either TC or FC regimen inductive chemotherapy, followed by concurrent chemoradiotherapy with two cycles of carboplatin (AUC=6) plus radiotherapy of 60-78 Gy to the nasopharynx and 60-70 Gy to the neck. The short-term efficacy and adverse events were observed.</p><p><b>RESULTS</b>More chemotherapy cycles were finished in TC group than in FC group (3.31 vs. 2.83, P = 0.043). There was no significant difference in short-term efficacy and 1-year survival rate between the two groups (P > 0.05). More grades 3-4 neutropenia appeared in TC group than in FC group (72.4% vs. 37.9%, P < 0.05) , whereas less thrombocytopenia and emesis occurred in TC than in FC group (P = 0.013 and 0.018, respectively).</p><p><b>CONCLUSIONS</b>The short-term efficacy of TC regimen in local advanced NPC is similar to that of FC regimen with tolerable adverse events. But the long-term outcomes and toxicities need to be further investigated.</p>

Significance of EGFR and p-ERK expression in nasopharyngeal carcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To detect the expression of EGFR and p-ERK in nasopharyngeal carcinoma (NPC) and investigate their clinical significance.</p><p><b>METHODS</b>Immunohistochemistry LSAB method was adopted to detect the expression of EGFR and p-ERK. Statistical analysis was performed using SPSS statistical software package (10.0) to correlate their expression with clinical characteristics and prognosis.</p><p><b>RESULTS</b>Positive staining for EGFR was observed in 39 of 55 cases (70.9%). The EGFR expression was correlated with clinical stage and gender. EGFR expression was correlated with poorer overall survival (OS) and shorter time to progression (TTP). Positive staining for p-ERK was observed in 29 of 55 cases (52.7%). There was a statistically significant association between positive p-ERK expression and advanced clinical stage. Positive p-ERK expression was correlated with poorer OS, disease-free survival (DFS) and TTP. EGFR expression was correlated with the expression of p-ERK. On multivariate analysis, age over 50 years was an independent poor prognostic factor for NPC. Both EGFR and p-ERK were not independent prognostic factors for NPC.</p><p><b>CONCLUSION</b>Expressions of EGFR and p-ERK are detected in NPC. Their abnormally high expression signifies poor prognosis in NPC patients.</p>