| Background and Objective: Nasopharyngeal carcinoma (NPC) is a very common head and neck malignant tumor in China. Distant metastasis is one of the main reasons for failure in nasopharyngeal carcinoma. China is the high incidence infection for hepatitis B virus (HBV), and according to the research, after infected by HBV, the immunity of liver function has enhanced. And another study has pointed out that the colonization of the malignant tumor will be affected by the immune microenvironment around tumor. Hence, the present study was to investigate the impact of HBV infection on liver metastasis of NPC.Methods: Retrospective analysis of677NPC patients without distant metastasis patient’s clinical data from Jiangxi Provincial Tumor Hospital Department of Radiation Oncology from June2008to December2010,. Enzyme‐linked immune‐sorbent assay measured the HBV serum markers, and have divided the patient into two groups: the experimental group (HBsAg‐positive) and the control group (HBsAg‐negative). Followed‐up observation of patient’s relapse, metastasis (liver metastasis, extra‐liver metastasis) and death situation. Chi‐square test was used to compare the two groups of patients, the survival rate and metastasis rate were calculated by Kaplan‐Meier, Log‐Rank test was used to test the differences of survival rate between two groups, and the Cox regression model was used for multivariate analysis.Results:(1) All patients’ median followed‐up period was40(6‐54) months. There were44patients occurred local‐regional recurrence,110patients occurred distant metastases, and10patients with recurrence and metastasis at the same time, and85patients emerged death. The1‐,3‐year overall survival rate for the whole group were98.5%,88.3%;1‐,3‐year free from local‐regional failure survival rate were99.1%,93.0%;1‐,3‐year free from distant metastasis survival rate were94.5%,84.1%and1‐,3‐year free from liver metastasis survival rate were98.1%,94.6%.(2) In the present research there were102cases divided into the experimental group, and leaving575cases into the control group. The experimental group and the control group1‐,2‐,3‐year free from liver metastasis rate were100.0%,100.0%,98.7%vs97.7%,96.1%,93.9%(P=0.03) separately;1‐,2‐,3‐year overall survival were100.0%,95.1%,91.2%vs98.3%,92.9%,87.8%(P=0.547) separately;1‐,2‐,3‐year free from local‐regional failure rate were99.0%,95.0%,92.4%vs99.1%,97.3%,93.1%(P=0.906) separately;1‐,2‐,3‐year free from distant metastasis rate were98.0%,92.0%,90.8%vs93.9%,88.3%,83.0%(P=0.106) separately; And1‐,2‐,3‐year free from extra‐liver metastasis rate were98.0%,92.0%,90.7%vs94.8%,89.6%,85.2%(P=0.291).(3) Univariate and multivariate analysis showed that: HBV infection was independent prognostic factor of NPC with liver metastasis. The independent prognostic factors of NPC patient’s overall survival rate included age, KPS score, N stage and overall stage. Meanwhile, N stage and overall stage were also independent prognostic factor of NPC patient’s free from distant metastasis survival rate.Conclusions:(1) HBV infection decreases the risk of liver metastasis for NPC patients.(2)Age, Karnofsky Performance Status, N stage and the total stage were independent prognostic factor impacted to overall survival of nasopharyngeal carcinoma, the older, poor Karnofsky Performance Status and late clinical stage were poor prognostic factor for overall survival. |
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