Pretreatment Serum Amyloid A and C-reactive Protein Comparing with Epstein-Barr Virus DNA as Prognostic Indicators in Patients with Nasopharyngeal Carcinoma: A Prospective Study.
- Author:
Qiu Yan CHEN
1
;
Qing Nan TANG
;
Lin Quan TANG
;
Wen Hui CHEN
;
Shan Shan GUO
;
Li Ting LIU
;
Chao Feng LI
;
Yang LI
;
Yu Jing LIANG
;
Xue Song SUN
;
Ling GUO
;
Hao Yuan MO
;
Rui SUN
;
Dong Hua LUO
;
Yu Ying FAN
;
Yan HE
;
Ming Yuan CHEN
;
Ka Jia CAO
;
Chao Nan QIAN
;
Xiang GUO
;
Hai Qiang MAI
Author Information
- Publication Type:Original Article
- Keywords: Nasopharyngeal carcinoma; Serum amyloid A; C-reactive protein; Epstein-Barr virus; Survival analysis; Prognosis
- MeSH: C-Reactive Protein*; DNA*; Herpesvirus 4, Human*; Humans; Observational Study; Prognosis; Prospective Studies*; Serum Amyloid A Protein*; Survival Analysis
- From:Cancer Research and Treatment 2018;50(3):701-711
- CountryRepublic of Korea
- Language:English
- Abstract: PURPOSE: The measuring Epstein-Barr virus (EBV) DNA is an important predictor of nasopharyngeal carcinoma (NPC). This study evaluated the predictive value of pretreatment serum amyloid A (SAA) and C-reactive protein (CRP) comparing with EBV DNA in patients with NPC. MATERIALS AND METHODS: In an observational study of 419 non-metastatic NPC patients, we prospectively evaluated the prognostic effects of pretreatment SAA, CRP, and EBV DNA on survival. The primary end-point was progress-free survival (PFS). RESULTS: The median level of SAA and CRP was 4.28 mg/L and 1.88 mg/L, respectively. For the high-SAA group (> 4.28 mg/L) versus the low-SAA (≤ 4.28 mg/L) group and the high-CRP group (> 1.88 mg/L) versus the low-CRP (≤ 1.88 mg/L) group, the 5-year PFS was 64.5% versus 73.1% (p=0.013) and 65.2% versus 73.3% (p=0.064), respectively. EBV DNA detection showed a superior predictive result, the 5-year PFS in the EBV DNA ≥ 1,500 copies/mL group was obviously different than the EBV DNA < 1,500 copies/mL group (62.2% versus 77.8%, p < 0.001). Multifactorial Cox regression analysis confirmed that in the PFS, the independent prognostic factors were including EBV DNA (hazard ratio [HR], 1.788; p=0.009), tumour stage (HR, 1.903; p=0.021), and node stage (HR, 1.498; p=0.049), but the SAA and CRP were not included in the independent prognostic factors. CONCLUSION: The results of SAA and CRP had a certain relationship with the prognosis of NPC, and the prognosis of patients with high level of SAA and CRP were poor. However, the predictive ability of SAA and CRP was lower than that of EBV DNA.
