The prognostic value of integration of pretreatment serum amyloid A (SAA)–EBV DNA (S-D) grade in patients with nasopharyngeal carcinoma

• Published in: Clinical and translational medicine Vol. 9; no. 1; pp. 1 - 8
• Main Authors: Li, Jianpei, Lai, Changchun, Peng, Songguo, Chen, Hao, Zhou, Lei, Chen, Yufeng, Chen, Shulin
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 06-01-2020; John Wiley & Sons, Inc; Wiley
• Subjects: Cancer; Cancer bioenergetics in translational medicine; Clinical medicine; Committees; Deoxyribonucleic acid; DNA; EBV DNA; Laboratories; Medical prognosis; Medicine; Medicine & Public Health; Nasopharyngeal carcinoma; Patients; Prognostic; SAA; Statistical analysis; Studies; Throat cancer; Nasopharyngeal carcinoma; EBV DNA; SAA; Prognostic
• ISSN: 2001-1326; 2001-1326
• DOI: 10.1186/s40169-019-0252-7

Background
Serum amyloid A (SAA) has been associated with the development and prognosis of cancer. The purpose of this study was to evaluate the predictive value of integration of pretreatment SAA–EBV DNA (S-D) grade and comparison with the TNM staging system in patients with nasopharyngeal carcinoma (NPC). The S-D grade was calculated based on the cut-off values of serum SAA and EBV DNA copy numbers which were determined by receiver operating characteristic (ROC) curves. We evaluated the prognostic value of pretreatment SAA, EBV DNA and S-D grade on overall survival (OS) of NPC patients. We also evaluated the predictive power of S-D grade with TNM staging system using 4 indices: concordance statistics (C-index), time-dependent ROC (ROCt) curve, net reclassification index (NRI) and integrated discrimination improvement (IDI).
Results
A total of 304 NPC patients were enrolled in this study. Multivariate analysis showed that TNM stage (P = 0.007), SAA (P = 0.013), and EBV DNA (P = 0.033) were independent prognostic factors in NPC. The S-D grade was divided into S-D grade 1, S-D grade 2, and S-D grade 3, which had more predictive accuracy for OS than TNM staging according to all 4 indices.
Conclusions
We found that the S-D grade could be used as a new tool to predict the OS in NPC patients.