Prognostic evaluation of Ki67 and derived neutrophil-lymphocyte ratio in patients with nasopharyngeal carcinoma / 国际肿瘤学杂志

ABSTRACT

Objective To investigate the prognostic value of Ki67 and derived neutrophil to lymphocyte ratio (dNLR) in clinical outcomes of patients with nasopharyngeal carcinoma.Methods A total of 180 patients with undifferentiated nasopharyngeal carcinoma confirmed by pathology from January 2011 to June 2015 in our hospital were enrolled.The neutrophil count and white blood cell count before radiotherapy and chemotherapy were collected,and dNLR was calculated.The positive rate of Ki67 in tumor tissues was detected by immunohistochemistry.The predictive values of Ki67 positive rate and dNLR on the overall survival (OS) rate and progression free survival (PFS) rate were evaluated.Results The 3-year OS rate prediction thresholds for patients with nasopharyngeal carcinoma by Ki67 and dNLR were 73.5％ and 2.21,respectively,which assessed by receiver operating characteristic (ROC) curve.The proportion of TNM Ⅲ-Ⅳ stage in patients with Ki67 ≥73.5％ was higher than that in Ki67 ＜ 73.5％ (100％ vs.89.7％,x2 =5.529,P =0.019);the proportion of T3-4 stage in dNLR ≥2.21 was higher than that in dNLR ＜ 2.21 (91.1％ vs.75.0％,x2 =6.228,P=0.013),and the proportion of TNM Ⅲ-Ⅳ stage in the dNLR≥2.21 group was higher than that in the dNLR ＜ 2.21 group (100％ vs.90.3％,x2 =4.355,P =0.037).Multivariate Cox regression analysis indicated that Ki67≥73.5％ (HR=3.011,95％CI1.874-4.982,P＜0.001) and dNLR≥2.21 (HR =2.234,95％CI1.274-3.382,P =0.001) were independent risk factors for OS in patients with nasopharyngeal carcinoma,while Ki67 ≥ 73.5％ (HR =2.842,95 ％ CI2.055-4.337,P ＜ 0.001) and dNLR ≥ 2.21 (HR =2.086,95％ CI1.452-2.983,P ＜0.001) were also independent risk factors for PFS in patients with nasopharyngeal carcinoma.Patients were divided into high-risk group,medium-risk group and low-risk group combined with Ki67 and dNLR,the 3-year OS rates were 20.0％,85.7％ and 95.3％ respectively,and the 3-year PFS rates were 12.0％,78.6％ and 89.4％ respectively,with statistical differences (x2 =15.521,P ＜ 0.001;x2 =15.849,P ＜ 0.001).Conclusion Ki67 and dNLR can effectively predict OS and PFS in patients with nasopharyngeal carcinoma,combined with Ki67 and dNLR can prognose stratification of patients with nasopharyngeal carcinoma.