{"title":"血浆 Epstein-Barr 病毒 DNA 阴性的非转移性鼻咽癌的免疫炎症和营养指标的预后价值。","authors":"Youliang Weng, Lishui Wu, Ying Li, Jing Wang, Zijie Wu, Xinyi Hong, Xiaoyong Liu, Jinghua Lai, Jun Lu, Sufang Qiu","doi":"10.1177/17588359241286489","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Plasma Epstein-Barr virus (EBV) DNA has been identified as a significant prognostic marker for nasopharyngeal carcinoma (NPC), yet there is limited research on the prognosis of NPC patients with negative EBV DNA.</p><p><strong>Objectives: </strong>We explore the prognostic value of comprehensive immune-inflammatory and nutritional indicators to offer personalized treatment recommendations and prognosis predictions for non-metastatic NPC patients with negative EBV DNA.</p><p><strong>Design: </strong>This was a retrospective study.</p><p><strong>Methods: </strong>This study retrospectively analyzed 257 non-metastatic NPC patients with negative EBV DNA between January 2015 and December 2019. The Kaplan-Meier survival curves evaluated survival endpoints, and group discrepancies were assessed with log-rank tests. Principal component analysis (PCA) reduced data dimensionality. Univariate and multivariate Cox regression analyses identified significant prognostic variables. Risk stratification was performed based on recursive partitioning analysis (RPA). A robust prognostic model was constructed by nomogram and evaluated by calibration curves, decision curves, and the time-dependent area under the curve analysis.</p><p><strong>Results: </strong>PCA was employed to compute the immune-inflammation index (III) and nutrition index (NI). Multivariate Cox regression analysis revealed lactate dehydrogenase, III, and NI as significant prognostic variables for overall survival (OS). Utilizing RPA, we stratified the risk into three categories: low-risk group (low III + high NI), middle-risk group (low III + low NI), and high-risk group (high III). Both the middle- (<i>p</i> = 0.025) and high-risk groups (<i>p</i> < 0.001) exhibited poorer OS compared with the low-risk group. The nomogram model exhibited superior predictive accuracy compared to tumor lymph node metastasis stage alone (C-index: 0.774 vs 0.679).</p><p><strong>Conclusion: </strong>Our study validated the prognostic significance of III and NI in non-metastatic NPC patients with negative EBV DNA. Additionally, a clinical risk stratification was constructed to offer valuable insights into the individualized treatment of these patients.</p>","PeriodicalId":23053,"journal":{"name":"Therapeutic Advances in Medical Oncology","volume":"16 ","pages":"17588359241286489"},"PeriodicalIF":4.3000,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11472370/pdf/","citationCount":"0","resultStr":"{\"title\":\"Prognostic value of immune-inflammatory and nutrition indicators in non-metastatic nasopharyngeal carcinoma with negative plasma Epstein-Barr virus DNA.\",\"authors\":\"Youliang Weng, Lishui Wu, Ying Li, Jing Wang, Zijie Wu, Xinyi Hong, Xiaoyong Liu, Jinghua Lai, Jun Lu, Sufang Qiu\",\"doi\":\"10.1177/17588359241286489\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Plasma Epstein-Barr virus (EBV) DNA has been identified as a significant prognostic marker for nasopharyngeal carcinoma (NPC), yet there is limited research on the prognosis of NPC patients with negative EBV DNA.</p><p><strong>Objectives: </strong>We explore the prognostic value of comprehensive immune-inflammatory and nutritional indicators to offer personalized treatment recommendations and prognosis predictions for non-metastatic NPC patients with negative EBV DNA.</p><p><strong>Design: </strong>This was a retrospective study.</p><p><strong>Methods: </strong>This study retrospectively analyzed 257 non-metastatic NPC patients with negative EBV DNA between January 2015 and December 2019. The Kaplan-Meier survival curves evaluated survival endpoints, and group discrepancies were assessed with log-rank tests. Principal component analysis (PCA) reduced data dimensionality. Univariate and multivariate Cox regression analyses identified significant prognostic variables. Risk stratification was performed based on recursive partitioning analysis (RPA). A robust prognostic model was constructed by nomogram and evaluated by calibration curves, decision curves, and the time-dependent area under the curve analysis.</p><p><strong>Results: </strong>PCA was employed to compute the immune-inflammation index (III) and nutrition index (NI). Multivariate Cox regression analysis revealed lactate dehydrogenase, III, and NI as significant prognostic variables for overall survival (OS). Utilizing RPA, we stratified the risk into three categories: low-risk group (low III + high NI), middle-risk group (low III + low NI), and high-risk group (high III). Both the middle- (<i>p</i> = 0.025) and high-risk groups (<i>p</i> < 0.001) exhibited poorer OS compared with the low-risk group. The nomogram model exhibited superior predictive accuracy compared to tumor lymph node metastasis stage alone (C-index: 0.774 vs 0.679).</p><p><strong>Conclusion: </strong>Our study validated the prognostic significance of III and NI in non-metastatic NPC patients with negative EBV DNA. 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引用次数: 0
摘要
背景：血浆爱泼斯坦-巴尔病毒（EBV）DNA已被确定为鼻咽癌（NPC）的一个重要预后标志物，但对EBV DNA阴性的鼻咽癌患者的预后研究却很有限：我们探讨了免疫炎症和营养综合指标的预后价值，以便为EBV DNA阴性的非转移性鼻咽癌患者提供个性化治疗建议和预后预测：这是一项回顾性研究：本研究回顾性分析了2015年1月至2019年12月期间257例EBV DNA阴性的非转移性鼻咽癌患者。Kaplan-Meier 生存曲线评估了生存终点，并用对数秩检验评估了组间差异。主成分分析（PCA）降低了数据维度。单变量和多变量考克斯回归分析确定了重要的预后变量。根据递归分区分析（RPA）进行了风险分层。通过提名图构建了一个稳健的预后模型，并通过校准曲线、决策曲线和随时间变化的曲线下面积分析进行了评估：结果：采用 PCA 计算了免疫炎症指数（III）和营养指数（NI）。多变量考克斯回归分析显示，乳酸脱氢酶、III和NI是影响总生存期（OS）的重要预后变量。利用 RPA，我们将风险分为三类：低风险组（低 III + 高 NI）、中风险组（低 III + 低 NI）和高风险组（高 III）。中危组（P = 0.025）和高危组（P = 0.025 结论：低危组和高危组的预后均好于中危组和高危组：我们的研究验证了 III 和 NI 在 EBV DNA 阴性的非转移性鼻咽癌患者中的预后意义。此外，我们还构建了临床风险分层，为这些患者的个体化治疗提供了有价值的见解。
Prognostic value of immune-inflammatory and nutrition indicators in non-metastatic nasopharyngeal carcinoma with negative plasma Epstein-Barr virus DNA.
Background: Plasma Epstein-Barr virus (EBV) DNA has been identified as a significant prognostic marker for nasopharyngeal carcinoma (NPC), yet there is limited research on the prognosis of NPC patients with negative EBV DNA.
Objectives: We explore the prognostic value of comprehensive immune-inflammatory and nutritional indicators to offer personalized treatment recommendations and prognosis predictions for non-metastatic NPC patients with negative EBV DNA.
Design: This was a retrospective study.
Methods: This study retrospectively analyzed 257 non-metastatic NPC patients with negative EBV DNA between January 2015 and December 2019. The Kaplan-Meier survival curves evaluated survival endpoints, and group discrepancies were assessed with log-rank tests. Principal component analysis (PCA) reduced data dimensionality. Univariate and multivariate Cox regression analyses identified significant prognostic variables. Risk stratification was performed based on recursive partitioning analysis (RPA). A robust prognostic model was constructed by nomogram and evaluated by calibration curves, decision curves, and the time-dependent area under the curve analysis.
Results: PCA was employed to compute the immune-inflammation index (III) and nutrition index (NI). Multivariate Cox regression analysis revealed lactate dehydrogenase, III, and NI as significant prognostic variables for overall survival (OS). Utilizing RPA, we stratified the risk into three categories: low-risk group (low III + high NI), middle-risk group (low III + low NI), and high-risk group (high III). Both the middle- (p = 0.025) and high-risk groups (p < 0.001) exhibited poorer OS compared with the low-risk group. The nomogram model exhibited superior predictive accuracy compared to tumor lymph node metastasis stage alone (C-index: 0.774 vs 0.679).
Conclusion: Our study validated the prognostic significance of III and NI in non-metastatic NPC patients with negative EBV DNA. Additionally, a clinical risk stratification was constructed to offer valuable insights into the individualized treatment of these patients.
期刊介绍：
Therapeutic Advances in Medical Oncology is an open access, peer-reviewed journal delivering the highest quality articles, reviews, and scholarly comment on pioneering efforts and innovative studies in the medical treatment of cancer. The journal has a strong clinical and pharmacological focus and is aimed at clinicians and researchers in medical oncology, providing a forum in print and online for publishing the highest quality articles in this area. This journal is a member of the Committee on Publication Ethics (COPE).
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