鼻咽癌新辅助化疗疗效预测模型的建立  

Establishment of a assessment model for the clinical efficacy of neoadjuvant chemotherapy in nasopharyngeal carcinoma

作　　者：全晋[1] 王阁[1] 向德兵 肖何[1] 

机构地区：[1]第三军医大学大坪医院野战外科研究所肿瘤中心,重庆400010 [2]重庆市江津区中心医院肿瘤科,402260

出　　处：《重庆医学》2014年第32期4283-4287,共5页Chongqing medicine

基　　金：国家自然科学基金资助项目(81272498)

摘　　要：目的建立鼻咽癌新辅助化疗近期疗效的模型,为个体化治疗提供依据。方法对鼻咽癌新辅助化疗的63例患者的临床资料进行回顾性分析,在综合分析影响疗效主要因素的基础上,采用Logistic回归分析构建预测模型。结果新辅助化疗鼻咽部病灶有效率为39.7%,颈部淋巴结转移灶有效率为50.8%。单因素分析显示,无远处转移、颅神经未受侵犯、血浆EBV阴性、Ki67高表达的患者对治疗更敏感。逐步Logistic回归分析显示,远处转移、颅神经受侵、血浆EBV情况影响新辅助化疗疗效。由此建立的预测模型为:Logit=-0.470-2.863×远处转移+1.328×颅神经受侵+3.639×EBV,其预测的灵敏度为79.4%,特异性为82.8%,阳性预测值为84.4%,阴性预测值为77.4%。结论远处转移、颅神经受侵情况和EBV感染是影响晚期鼻咽癌患者新辅助化疗疗效的重要指标,由此建立的预测模型为鼻咽癌患者个体化治疗提供初步的依据。Objective To establish a model to predict the clinical response of neoadjuvant chemotherapy for nasopharyngeal carcinoma,and provide basis for the individual treatment.Methods The clinical data of 63 cases of advanced nasopharyngeal carcinoma patients who have received neoadjuvant chemotherapy in the past 2years were analyzed retrospectively.Univariate and multivariate analyses were performed using the Logistic analyses to identify efficacy factors.Results The response rate in nasopharyngeal tumor and lymph node metastasis were 39.7%and 50.8%,respectively.Single factor analysis showed that patients with no distant metastasis,cranial nerve inviolated,EBV negative and high expression of Ki67 were more sensitive to therapy.Logistic analysis showed that the influencing factors for the effect of the new chemotherapy include：distant metastasis,cranial nerve inviolated and EBV.Thus,the prediction model would be：Logit=-0.470-2.863×distant metastasis ＋1.328×cranial nerve invasion＋3.639×EBV,its sensitivity,specificity,positive predictive value and negative predictive value were 79.4%,82.8%,84.4% and 77.4%.Conclusion The distant metastasis,cranial nerve invasion and EBV infection were important predictive factors for neoadjuvant chemotherapy of nasopharyngeal carcinoma.This model could be used to predict the response of patients with nasopharyngeal carcinoma.

关 键 词：鼻咽肿瘤 新辅助化疗 预测模型 

分 类 号：R739.63[医药卫生—肿瘤]