Cancer Res Treat.  2018 Jul;50(3):701-711. 10.4143/crt.2017.180.

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

• Chen QY
• Tang QN
• Tang LQ
• Chen WH
• Guo SS
• Liu LT
• Li CF
• Li Y
• Liang YJ
• Sun XS
• Guo L
• Mo HY
• Sun R
• Luo DH
• Fan YY
• He Y
• Chen MY
• Cao KJ
• Qian CN
• Guo X
• Mai HQ

• KMID: 2417859
• DOI: http://doi.org/10.4143/crt.2017.180

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.

Keyword

Nasopharyngeal carcinoma; Serum amyloid A; C-reactive protein; Epstein-Barr virus; Survival analysis; Prognosis

MeSH Terms

C-Reactive Protein*
DNA*
Herpesvirus 4, Human*
Humans
Observational Study
Prognosis
Prospective Studies*
Serum Amyloid A Protein*
Survival Analysis
C-Reactive Protein
DNA
Serum Amyloid A Protein

Figure

• 

  Fig. 1. Cohort definition and exclusion. NPC, nasopharyngeal carcinoma; SAA, serum amyloid A; CRP, C-reactive protein; EBV, Epstein-Barr virus; PFS, progression-free survival; OS, overall survival; DMFS, distant metastasis-free survival; LRFS, locoregional relapse-free survival.

• 

  Fig. 2. Kaplan-Meier curves of progression-free survival according to different groups in 419 NPC patients. (A) Low-SAA (SAA ≤ 4.28 mg/L) and high-SAA (SAA > 4.28 mg/L) group. (B) Low-CRP (CRP ≤ 1.88 mg/L) and high-CRP (CRP > 1.88 mg/L) group. (C) Low-SAA & CRP (SAA ≤ 4.28 mg/L and CRP ≤ 1.88 mg/L) and high-SAA & CRP (SAA > 4.28 mg/L or CRP > 1.88 mg/L) group. (D) Low-EBV DNA (EBV DNA < 1,500 copies/mL) and high-EBV DNA (EBV DNA ≥ 1,500 copies/mL) group. NPC, nasopharyngeal carcinoma; SAA, serum amyloid A; CRP, C-reactive protein; EBV, Epstein-Barr virus.

Reference

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