The Correlation Study Between Pretreatment Biochemistry-based Biomarkers And Prognosis In Patients With Locally Advanced Nasopharyngeal Carcinoma

Purpose: Biochemistry-based biomarkers have been suggested to predict the prognosis of nasopharyngeal carcinoma(NPC)patients in recent years.However,the prognostic value of aforementioned indexes in female and male locally advanced nasopharyngeal carcinoma(LA-NPC)patients,respectively,remains unknown.Within the context,the aim of present study is to seriously and comprehensively explore the predictive role of biochemistry-based biomarkers in male and female LA-NPC patients,respectively.Methods: A total of 296 patients with Ⅲ/ⅣA,B NPC,admitted in hospital between June 2014 and December 2018,were enrolled.The optimal cut-off values for biochemical parameters were defined as the median values of each marker.The association between pretreatment biochemistry-based biomarkers and overall survival(OS)and progression-free survival(PFS)were analyzed.The survival curves were determined by the Kaplan–Meier method,and differences were compared with log-rank test.Hazard ratios(HRs)and 95% confidence intervals(CIs)in univariate analysis(UVA)and multivariate analysis(MVA)were calculated using the Cox proportional hazard model.Statistical analyses were carried out using the package IBM SPSS version 25.0 software.P value < 0.05(two-tailed)were identified as statistically significant.Results: In male patients,in UVA,clinical stage(HR = 2.200,P =0.025),AAPR(HR = 2.516,P = 0.015),AGR(HR = 2.915,P = 0.005)and LDH(HR = 0.281,P = 0.002)were associated with OS,and clinical stage(HR = 2.145,P = 0.015)and LDH(HR = 0.378,P = 0.004)were significantly related to PFS.In MVA,AGR(HR = 2.291,P = 0.036)and LDH(HR = 0.305,P = 0.004)were identified as independent prognostic factors for OS.With regards to the end point of PFS,clinical stage(HR =2.165,P = 0.014)and LDH(HR = 0.375,P = 0.004)were defined as independent prognostic indicators.However,in females,in UVA,histology was significantly related to OS(HR = 0.058,P = 0.011)and PFS(HR =0.044,P = 0.007).Furthermore,in MVA,histology(P = 0.011 and P =0.007,respectively)was identified as an independent prognostic factor for OS and PFS.Conclusion: The study showed that clinical biochemistry-based indexes,such as AAPR,AGR,LDH,may serve as tools for predicting prognosis of male LA-NPC patients.However,the predictive value of the aforementioned indicators in female patients needs to be further studied.Given that the ample size of this retrospective study is relatively small,and the mean follow-up duration is short,large,prospective studies should be performed to approve our conclusions in the future.