Abstract
This study aimed to evaluate the correlation between circulating lymphocyte subsets and clinical variables, and design an effective prognostic model for distant metastasis-free survival (DMFS) in NPC. In this study, subsets of circulating lymphocytes were determined in 719 non-metastatic NPC patients before treatment. Overall survival and DMFS was monitored. Significant prognostic factors were identified using univariate and multivariate analyses. Results showed that the percentage of CD19+ lymphocytes correlated negatively with TNM stage (r = −0.082, P = 0.028). Patients with higher CD4/CD8 ratios (≥ 1.77) showed better 5-year DMFS than patients with lower ratios (91.9% vs. 85.4%, P < 0.001). Multivariate analysis revealed that CD4/CD8 ratio (HR, 0.450; 95% confidence interval [CI], 0.266–0.760; P = 0.003) and N classification (HR, 2.294; 95% CI, 1.370–3.839; P = 0.002) were independently prognostic factors for DMFS. The prognostic N-R model was developed and divided patients into three groups: (1) low-risk (early N stage and CD4/CD8 ratio ≥ 1.77); (2) intermediate-risk (advanced N stage or CD4/CD8 ratio < 1.77) and (3) high-risk (advanced N stage and CD4/CD8 ratio < 1.77) of distant metastasis. In conclusion our prognostic model, based on clinical N stage and CD4/CD8 ratio, may predict the risk of distant metastasis, allowing individualized treatment for NPC.
Highlights
Nasopharyngeal carcinoma (NPC) is a distinct type of head and neck cancer owing to its extremely unbalanced endemic distribution, pathology and clinical attributes [1]
This study aimed to evaluate the correlation between circulating lymphocyte subsets and clinical variables, and design an effective prognostic model for distant metastasis-free survival (DMFS) in NPC
We aimed to examine the correlation between lymphocyte subset distribution and clinical variables in order to design a convenient and effective prognostic model predicting distant metastasis in NPC patients
Summary
Nasopharyngeal carcinoma (NPC) is a distinct type of head and neck cancer owing to its extremely unbalanced endemic distribution, pathology and clinical attributes [1]. It has a high incidence rate, ranging from 20 to 30 cases per 100 000 people in southern China and the surrounding areas [1, 2]. There is much interest in developing additional prognostic factors to permit more accurate patient stratification to evaluate individual prognosis Such factors will improve clinical decision-making, and may help guide the provision of individualized treatment [8]
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