血液标志物在局部晚期鼻咽癌中的预测价值  

Prognostic values of hematological biomarkers in locoregionally advanced nasopharyngeal carcinoma

作　　者：孙健达 熊俊[1] 张汉雄[1] 陈意标[1] SUNJianda;XIONG Jun;ZHANG Hanxiong;CHEN Yibiao(Department of Radiation Oncology,Meizhou People’s Hospital,Meizhou 514031,Guangdong Province,China)

机构地区：[1]广东省梅州市人民医院放疗科

出　　处：《中国癌症杂志》2019年第7期528-534,共7页China Oncology

摘　　要：背景与目的:治疗前血液标志物在尼妥珠单抗治疗的局部晚期鼻咽癌患者中的预测作用目前尚未明确。探讨治疗前血液标志物与鼻咽癌分期之间的相关性,以及其在治疗后近期疗效的预测作用。方法:选择2015年5月—2018年10月收治的Ⅲ~Ⅳa期鼻咽癌患者共83例,所有患者均接受放化疗综合治疗,放疗过程中予以尼妥珠单抗治疗。治疗前检测患者的血小板计数、淋巴细胞计数、血小板与淋巴细胞比值(platelet to lymphocyte ratio,PLR)及EB病毒(Epstein-Barr virus,EBV)DNA拷贝数。结果:治疗前血小板计数、PLR及血浆EBV DNA水平均未显示出与鼻咽癌患者的T分期、N分期、临床分期及治疗后的肿瘤缓解程度存在显著的相关性。治疗前联合血小板计数和淋巴细胞计数与治疗后颈部淋巴结的缓解程度显著相关,血小板计数及淋巴细胞计数均正常的患者颈部淋巴结完全缓解率显著升高。结论:对于尼妥珠单抗治疗的局部晚期鼻咽癌,治疗前联合血小板计数和淋巴细胞计数较单独血小板计数、PLR和血浆EBV DNA水平更能预测患者的近期疗效。Background and purpose:The prognostic values of hematological biomarkers in locoregionally advanced nasopharyngeal carcinoma(NPC)patients treated with nimotuzumab remains unclear.This study investigated the association of pretreatment hematological biomarkers with staging,and its prognostic values for short-term efficacy after treatment.Methods:A total of 83 patients with stageⅢor stageⅣa NPC were treated in Meizhou People’s Hospital from Apr.2015 to Oct.2018.All patients received chemoradiotherapy,and nimotuzumab was administered concurrently with radiotherapy.Platelet count,lymphocyte count,platelet to lymphocyte ratio(PLR)and Epstein-Barr virus(EBV)DNA were collected before treatment.Results:Pretreatment platelet count,PLR and EBV DNA levels were neither significantly associated with T stage,N stage and overall stage,nor the response extent of tumor after treatment.Pretreatment combination of platelet count and lymphocyte count showed significant correlation with the response rates of cervical lymph nodes after treatment.Complete response(CR)rates of cervical lymph nodes were significantly higher in patients without elevated platelet count and lymphocyte count.Conclusion:Pretreatment combination of platelet count and lymphocyte count,but not platelet count,PLR,or EBV DNA levels alone,could predict the short-term efficacy in locoregionally advanced NPC patients treated with nimotuzumab.

关 键 词：鼻咽肿瘤 放化疗 尼妥珠单抗 生物标志物 EB病毒 疗效 

分 类 号：R739.62[医药卫生—肿瘤] R739.63[医药卫生—临床医学]