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Title: High-Sensitivity C-Reactive Protein Complements Plasma Epstein-Barr Virus Deoxyribonucleic Acid Prognostication in Nasopharyngeal Carcinoma: A Large-Scale Retrospective and Prospective Cohort Study

Abstract

Purpose: To evaluate the effects of combining the assessment of circulating high-sensitivity C-reactive protein (hs-CRP) with that of Epstein-Barr virus DNA (EBV DNA) in the pretherapy prognostication of nasopharyngeal carcinoma (NPC). Patients and Methods: Three independent cohorts of NPC patients (training set of n=3113, internal validation set of n=1556, and prospective validation set of n=1668) were studied. Determinants of disease-free survival, distant metastasis–free survival, and overall survival were assessed by multivariate analysis. Hazard ratios and survival probabilities of the patient groups, segregated by clinical stage (T1-2N0-1M0, T3-4N0-1M0, T1-2N2-3M0, and T3-4N2-3M0) and EBV DNA load (low or high) alone, and also according to hs-CRP level (low or high), were compared. Results: Elevated hs-CRP and EBV DNA levels were significantly correlated with poor disease-free survival, distant metastasis–free survival, and overall survival in both the training and validation sets. Associations were similar and remained significant after excluding patients with cardiovascular disease, diabetes, and chronic hepatitis B. Patients with advanced-stage disease were segregated by high EBV DNA levels and high hs-CRP level into a poorest-risk group, and participants with either high EBV DNA but low hs-CRP level or high hs-CRP but low EBV DNA values had poorer survival compared with the bottom values formore » both biomarkers. These findings demonstrate a significant improvement in the prognostic ability of conventional advanced NPC staging. Conclusion: Baseline plasma EBV DNA and serum hs-CRP levels were significantly correlated with survival in NPC patients. The combined interpretation of EBV DNA with hs-CRP levels led to refinement of the risks for the patient subsets, with improved risk discrimination in patients with advanced-stage disease.« less

Authors:
 [1];  [1]; ;  [1]; ; ; ; ; ;  [2];  [1]; ; ;  [1];  [1];  [1];
  1. Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University, Guangzhou (China)
  2. ZhongShan School of Medicine, Sun Yat-sen University, Guangzhou (China)
Publication Date:
OSTI Identifier:
22458599
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 91; Journal Issue: 2; Other Information: Copyright (c) 2015 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0360-3016
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BIOLOGICAL MARKERS; CARCINOMAS; CARDIOVASCULAR DISEASES; COMPARATIVE EVALUATIONS; COMPLEMENT; DNA; GLOBULINS; HAZARDS; HEPATITIS; IMMUNITY; METASTASES; MULTIVARIATE ANALYSIS; ONCOGENIC VIRUSES; PATIENTS; SENSITIVITY; TRAINING; VALIDATION

Citation Formats

Tang, Lin-Quan, Department of Nasopharyngeal Carcinoma, Sun Yat-sen University, Guangzhou, Li, Chao-Feng, Department of Information Technology, Sun Yat-sen University, Guangzhou, Chen, Qiu-Yan, Zhang, Lu, Department of Nasopharyngeal Carcinoma, Sun Yat-sen University, Guangzhou, Lai, Xiao-Ping, He, Yun, Xu, Yun-Xiu-Xiu, Hu, Dong-Peng, Wen, Shi-Hua, Peng, Yu-Tuan, Chen, Wen-Hui, Liu, Huai, Guo, Shan-Shan, Liu, Li-Ting, Department of Nasopharyngeal Carcinoma, Sun Yat-sen University, Guangzhou, Li, Jing, Zhang, Jing-Ping, Department of Clinical Laboratory, Sun Yat-sen University, Guangzhou, and others, and. High-Sensitivity C-Reactive Protein Complements Plasma Epstein-Barr Virus Deoxyribonucleic Acid Prognostication in Nasopharyngeal Carcinoma: A Large-Scale Retrospective and Prospective Cohort Study. United States: N. p., 2015. Web. doi:10.1016/J.IJROBP.2014.10.005.
Tang, Lin-Quan, Department of Nasopharyngeal Carcinoma, Sun Yat-sen University, Guangzhou, Li, Chao-Feng, Department of Information Technology, Sun Yat-sen University, Guangzhou, Chen, Qiu-Yan, Zhang, Lu, Department of Nasopharyngeal Carcinoma, Sun Yat-sen University, Guangzhou, Lai, Xiao-Ping, He, Yun, Xu, Yun-Xiu-Xiu, Hu, Dong-Peng, Wen, Shi-Hua, Peng, Yu-Tuan, Chen, Wen-Hui, Liu, Huai, Guo, Shan-Shan, Liu, Li-Ting, Department of Nasopharyngeal Carcinoma, Sun Yat-sen University, Guangzhou, Li, Jing, Zhang, Jing-Ping, Department of Clinical Laboratory, Sun Yat-sen University, Guangzhou, & others, and. High-Sensitivity C-Reactive Protein Complements Plasma Epstein-Barr Virus Deoxyribonucleic Acid Prognostication in Nasopharyngeal Carcinoma: A Large-Scale Retrospective and Prospective Cohort Study. United States. https://doi.org/10.1016/J.IJROBP.2014.10.005
Tang, Lin-Quan, Department of Nasopharyngeal Carcinoma, Sun Yat-sen University, Guangzhou, Li, Chao-Feng, Department of Information Technology, Sun Yat-sen University, Guangzhou, Chen, Qiu-Yan, Zhang, Lu, Department of Nasopharyngeal Carcinoma, Sun Yat-sen University, Guangzhou, Lai, Xiao-Ping, He, Yun, Xu, Yun-Xiu-Xiu, Hu, Dong-Peng, Wen, Shi-Hua, Peng, Yu-Tuan, Chen, Wen-Hui, Liu, Huai, Guo, Shan-Shan, Liu, Li-Ting, Department of Nasopharyngeal Carcinoma, Sun Yat-sen University, Guangzhou, Li, Jing, Zhang, Jing-Ping, Department of Clinical Laboratory, Sun Yat-sen University, Guangzhou, and others, and. 2015. "High-Sensitivity C-Reactive Protein Complements Plasma Epstein-Barr Virus Deoxyribonucleic Acid Prognostication in Nasopharyngeal Carcinoma: A Large-Scale Retrospective and Prospective Cohort Study". United States. https://doi.org/10.1016/J.IJROBP.2014.10.005.
@article{osti_22458599,
title = {High-Sensitivity C-Reactive Protein Complements Plasma Epstein-Barr Virus Deoxyribonucleic Acid Prognostication in Nasopharyngeal Carcinoma: A Large-Scale Retrospective and Prospective Cohort Study},
author = {Tang, Lin-Quan and Department of Nasopharyngeal Carcinoma, Sun Yat-sen University, Guangzhou and Li, Chao-Feng and Department of Information Technology, Sun Yat-sen University, Guangzhou and Chen, Qiu-Yan and Zhang, Lu and Department of Nasopharyngeal Carcinoma, Sun Yat-sen University, Guangzhou and Lai, Xiao-Ping and He, Yun and Xu, Yun-Xiu-Xiu and Hu, Dong-Peng and Wen, Shi-Hua and Peng, Yu-Tuan and Chen, Wen-Hui and Liu, Huai and Guo, Shan-Shan and Liu, Li-Ting and Department of Nasopharyngeal Carcinoma, Sun Yat-sen University, Guangzhou and Li, Jing and Zhang, Jing-Ping and Department of Clinical Laboratory, Sun Yat-sen University, Guangzhou and others, and},
abstractNote = {Purpose: To evaluate the effects of combining the assessment of circulating high-sensitivity C-reactive protein (hs-CRP) with that of Epstein-Barr virus DNA (EBV DNA) in the pretherapy prognostication of nasopharyngeal carcinoma (NPC). Patients and Methods: Three independent cohorts of NPC patients (training set of n=3113, internal validation set of n=1556, and prospective validation set of n=1668) were studied. Determinants of disease-free survival, distant metastasis–free survival, and overall survival were assessed by multivariate analysis. Hazard ratios and survival probabilities of the patient groups, segregated by clinical stage (T1-2N0-1M0, T3-4N0-1M0, T1-2N2-3M0, and T3-4N2-3M0) and EBV DNA load (low or high) alone, and also according to hs-CRP level (low or high), were compared. Results: Elevated hs-CRP and EBV DNA levels were significantly correlated with poor disease-free survival, distant metastasis–free survival, and overall survival in both the training and validation sets. Associations were similar and remained significant after excluding patients with cardiovascular disease, diabetes, and chronic hepatitis B. Patients with advanced-stage disease were segregated by high EBV DNA levels and high hs-CRP level into a poorest-risk group, and participants with either high EBV DNA but low hs-CRP level or high hs-CRP but low EBV DNA values had poorer survival compared with the bottom values for both biomarkers. These findings demonstrate a significant improvement in the prognostic ability of conventional advanced NPC staging. Conclusion: Baseline plasma EBV DNA and serum hs-CRP levels were significantly correlated with survival in NPC patients. The combined interpretation of EBV DNA with hs-CRP levels led to refinement of the risks for the patient subsets, with improved risk discrimination in patients with advanced-stage disease.},
doi = {10.1016/J.IJROBP.2014.10.005},
url = {https://www.osti.gov/biblio/22458599}, journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 2,
volume = 91,
place = {United States},
year = {Sun Feb 01 00:00:00 EST 2015},
month = {Sun Feb 01 00:00:00 EST 2015}
}