RESUMO
BACKGROUND: The prognostic value of serum alkaline phosphatase (S-ALP) has not been fully validated for nasopharyngeal carcinoma (NPC). MATERIALS AND METHODS: S-ALP levels were measured in 601 patients newly diagnosed with NPC before radical treatment, and possible associations of these levels with 5-year overall survival (OS) and tumor-free survival (TFS) were explored using univariate and multivariate analyses. RESULTS: Elevated pretreatment S-ALP (>85 U/L) was significantly less frequent among patients classified as T1+2 or stage I+II than among those classified as T3+4 or stage III+IV. Multivariate analysis showed that elevated pretreatment S-ALP (>85 U/L), age, T classification and N stage were independent predictors of poor OS and TFS. CONCLUSIONS: Pretreatment S-ALP may be a reliable biomarker to evaluate the long-term prognosis of patients with NPC.
Assuntos
Fosfatase Alcalina/sangue , Biomarcadores Tumorais/sangue , Neoplasias Nasofaríngeas/sangue , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma , Criança , Estudos de Coortes , Intervalo Livre de Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Carcinoma Nasofaríngeo , Neoplasias Nasofaríngeas/patologia , Prognóstico , Modelos de Riscos Proporcionais , Estudos Prospectivos , Adulto JovemRESUMO
Photodynamic therapy (PDT) is a promising treatment for nasopharyngeal carcinoma. However, recurrence and metastasis of the tumor after PDT remains problematic. In this study we investigated VEGF and PCNA expression in tumor tissues after 5-ALA-PDT. BALB/c nude mice with NPC tumors of similar size were randomly assigned to three groups (n=10 each). In the two treatment groups, mice were administrated 5-ALA intratumorally at a dose of 100 mg/kg and 3-3.5 h prior to laser irradiation (630 nm, 100 J/cm(2), 100 mW/cm(2)). The mice in one of the treatment groups were sacrificed at 24 h after PDT. The other treatment group and control group mice were sacrificed 14 days after PDT, and the tumor weights were determined for all three groups. Mean tumor weights at 14 days after PDT were 1.353+/-0.204 g in the treatment group and 3.124+/-0.380 g in the control group (p<0.001). Results showed the VEGF level in tumor tissues at 24 h after PDT was slightly higher than that in the control group, while it was down-regulated at 14 days after PDT. The PCNA level was not significantly different in tumor tissues among the three groups, but it was lower in degenerated tumor cells 24 h after PDT. Our results suggest that VEGF may play a role in tumor recurrence and metastasis following PDT. Residual tumor cells escaped from PDT is the main reason for tumor recurrence.
