Investigation On The Prognosis Value Of GLO-PLR In Patients With Nasopharyngeal Carcinoma

Purpose: The aim of this study is to explore the prognosis value of routine pre-treatment hematological parameters and GLO-PLR in nasopharyngeal carcinoma(NPC)patients.Methods: The hematological parameters and clinical data of patients with nasopharyngeal carcinoma were collected from January 2012 to December 2013 in Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology.The survival data were obtained by regularly following the patients with nasopharyngeal carcinoma.X-tile software was used to calculate the cut off values of hematological parameters.SPSS 24.0 software was used for statistical analysis.The relationship between hematological parameters and overall survival(OS)and progression-free survival(PFS)of patients with NPC was analyzed by Kaplan-Meier method Cox proportional hazard model.Based on the results of the multivariate analysis,we proposed a new biomarker called GLO-PLR,which was combined globulin(GLO)and platelet-to-lymphocyte ratio(PLR).Comparisons between groups were performed using the χ2 test for categorical variables.The discrimination abilities of the factors to predict prognosis were assessed using receiver operating characteristic(ROC)area under curve(AUC).Results: This study included 179 patients with NPC.Multivariate analysis shows that pre-treatment PLR >130.7(HR = 0.44,95% CI: 0.21-0.91,p = 0.029),pre-treatment albumin(ALB)≤37.2g/L(HR = 2.49,95% CI: 1.17-5.30,p = 0.018),pre-treatment GLO>35.8g/L(HR = 0.44,95% CI: 0.21-0.90,p = 0.024)are independent risk factors for 5-year overall survival(OS)in patients with nasopharyngeal carcinoma.In addition,pre-treatment PLR >130.7(HR = 0.47,95% CI: 0.25-0.90,p = 0.022),pre-treatment GLO >35.8g/L(HR = 0.37,95% CI: 0.19-0.72,p = 0.001)are 5-year progression-free survival(PFS)for patients with NPC.GLO-PLR significantly correlated with T stage(p = 0.002),N stage(p = 0.027)and clinical stage(p = 0.012)in patients with NPC,respectively.The 5-year OS rates for patients in the low-risk group,intermediate-risk group,and high-risk group were 93.3% ± 1.4%,71.2% ± 10.8%,and 58.8% ± 25.1%,respectively.The 5-year PFS rates for patients in the low-risk group,intermediate-risk group,and high-risk group were 89.9% ± 6.25%,67.1% ± 10.9%,and 52.9% ± 25.3%,respectively.The OS discrimination ability of the GLO-PLR,as assessed by AUC,was 0.714(95% CI: 0.621-0.806,p < 0.001)and it was higher than that of GLO and PLR.The PFS discrimination ability of the GLO-PLR,as assessed by AUC,was 0.696(95% CI: 0.605-0.786,p<0.001)and is was higher than that of GLO and PLR.Conclusion: Pre-treatment PLR,ALB and GLO are independent predictors of 5 years OS in patients with NPC.Pre-treatment PLR and GLO are independent predictors of 5 years FPS in patients with nasopharyngeal carcinoma.Compared with other hematological parameters,GLO-PLR has a better ability to predict the prognosis of NPC.In addition,risk stratification of GLO-PLR was positively associated with poor prognosis in patients.