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A novel statistical prognostic score model that includes serum CXCL5 levels and clinical classification predicts risk of disease progression and survival of nasopharyngeal carcinoma patients.

Zhang H, Xia W, Lu X, Sun R, Wang L, Zheng L, Ye Y, Bao Y, Xiang Y, Guo X - PLoS ONE (2013)

Bottom Line: Sex, age, histology, T classification, clinical classification and local recurrence were not associated with sCXCL5 levels.Furthermore, this novel model successfully divided the patients into four risk subgroups in the training set, the testing set and the entire set of patients.The novel statistical C-C model, which includes sCXCL5 levels and clinical classification, could be helpful in predicting the prognosis of NPC patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, Guangzhou, China.

ABSTRACT

Background: Aberrant expression of C-X-C motif chemokine 5 (CXCL5) contributes to the progression of various cancers. This study analyzed the clinical significance of serum CXCL5 (sCXCL5) levels of nasopharyngeal carcinoma (NPC) patients, with the goal of building a novel prognostic score model.

Experimental design: Serum samples were collected prior to treatment from 290 NPC patients for the detection of sCXCL5 with ELISA. Half of the patients (n = 145) were randomly assigned to the training set to generate the sCXCL5 cutoff point using receiver operator characteristic (ROC) analysis, while the other half (n = 145) were assigned to the testing set for validation. Associations between sCXCL5 levels and clinical characteristics were analyzed. A prognostic score model was built using independent predictors derived from multivariate analysis. A concordance index (C-Index) was used to evaluate prognostic ability.

Results: The sCXCL5 cutoff point was 0.805 ng/ml. Sex, age, histology, T classification, clinical classification and local recurrence were not associated with sCXCL5 levels. However, sCXCL5 levels were positively associated with N classification, distant metastasis and disease progression (P<0.05). A high sCXCL5 level predicted poor 6-year overall survival (OS), poor 6-year distant metastasis-free survival (DMFS), and poor 6-year progression-free survival (PFS). A prognostic score model was subsequently constructed based on sCXCL5 levels and clinical classification (C-C model), which are independent predictors of OS, DMFS, and PFS, as confirmed by the multivariate analysis. Furthermore, this novel model successfully divided the patients into four risk subgroups in the training set, the testing set and the entire set of patients. The C-Indices were 0.751 and 0.762 for the training set and the testing set, respectively.

Conclusions: sCXCL5 level was determined to be an independent prognostic factor for NPC patients. The novel statistical C-C model, which includes sCXCL5 levels and clinical classification, could be helpful in predicting the prognosis of NPC patients.

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The C-C model-derived survival curves for all 290 nasopharyngeal carcinoma patients.The follow-up prognoses of all 290 nasopharyngeal carcinoma patients were clearly identified by the four risk subgroups of C-C model. (A) The overall survival curves for the L, IL, IH, and H risk subgroups of the C-C model; (B) The distant metastasis-free survival curves for the L, IL, IH, and H risk subgroups of the C-C model; (C) The progression-free survival curves for the L, IL, IH, and H risk subgroups of the C-C model; and (D) The local-regional recurrence-free survival curves for the L, IL, IH, and H risk subgroups of the C-C model. L, low risk, n = 24; IL, intermediate-low risk, n = 77; IH, intermediate-high risk, n = 130; H, high-risk, n = 59.
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pone-0057830-g004: The C-C model-derived survival curves for all 290 nasopharyngeal carcinoma patients.The follow-up prognoses of all 290 nasopharyngeal carcinoma patients were clearly identified by the four risk subgroups of C-C model. (A) The overall survival curves for the L, IL, IH, and H risk subgroups of the C-C model; (B) The distant metastasis-free survival curves for the L, IL, IH, and H risk subgroups of the C-C model; (C) The progression-free survival curves for the L, IL, IH, and H risk subgroups of the C-C model; and (D) The local-regional recurrence-free survival curves for the L, IL, IH, and H risk subgroups of the C-C model. L, low risk, n = 24; IL, intermediate-low risk, n = 77; IH, intermediate-high risk, n = 130; H, high-risk, n = 59.

Mentions: We further performed survival analyses for the patients in the training set, the testing set and all of the patients combined, with the results indicating that the OS, DMFS, LRRFS, and PFS curves discriminated between the four risk subgroups in the C-C model more clearly than clinical classification alone. In the training set, the 6-year-OS rates were 100%, 79%, 61%, and 27% for the L, IL, IH and H risk groups, respectively. These rates were 100%, 92%, 70%, and 41% for clinical class I, II, III and IVa-b patients, respectively (Table 4; Figures 2, 3, 4 show the complete follow-up). The C-Indices for clinical classification in the training set and testing set were 0.742 and 0.733, respectively, while these values were 0.751 and 0.762 for the C-C model. These results confirmed that the C-C model was more precise in predicting the prognosis of NPC patients than clinical classification alone.


A novel statistical prognostic score model that includes serum CXCL5 levels and clinical classification predicts risk of disease progression and survival of nasopharyngeal carcinoma patients.

Zhang H, Xia W, Lu X, Sun R, Wang L, Zheng L, Ye Y, Bao Y, Xiang Y, Guo X - PLoS ONE (2013)

The C-C model-derived survival curves for all 290 nasopharyngeal carcinoma patients.The follow-up prognoses of all 290 nasopharyngeal carcinoma patients were clearly identified by the four risk subgroups of C-C model. (A) The overall survival curves for the L, IL, IH, and H risk subgroups of the C-C model; (B) The distant metastasis-free survival curves for the L, IL, IH, and H risk subgroups of the C-C model; (C) The progression-free survival curves for the L, IL, IH, and H risk subgroups of the C-C model; and (D) The local-regional recurrence-free survival curves for the L, IL, IH, and H risk subgroups of the C-C model. L, low risk, n = 24; IL, intermediate-low risk, n = 77; IH, intermediate-high risk, n = 130; H, high-risk, n = 59.
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Related In: Results  -  Collection

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getmorefigures.php?uid=PMC3585222&req=5

pone-0057830-g004: The C-C model-derived survival curves for all 290 nasopharyngeal carcinoma patients.The follow-up prognoses of all 290 nasopharyngeal carcinoma patients were clearly identified by the four risk subgroups of C-C model. (A) The overall survival curves for the L, IL, IH, and H risk subgroups of the C-C model; (B) The distant metastasis-free survival curves for the L, IL, IH, and H risk subgroups of the C-C model; (C) The progression-free survival curves for the L, IL, IH, and H risk subgroups of the C-C model; and (D) The local-regional recurrence-free survival curves for the L, IL, IH, and H risk subgroups of the C-C model. L, low risk, n = 24; IL, intermediate-low risk, n = 77; IH, intermediate-high risk, n = 130; H, high-risk, n = 59.
Mentions: We further performed survival analyses for the patients in the training set, the testing set and all of the patients combined, with the results indicating that the OS, DMFS, LRRFS, and PFS curves discriminated between the four risk subgroups in the C-C model more clearly than clinical classification alone. In the training set, the 6-year-OS rates were 100%, 79%, 61%, and 27% for the L, IL, IH and H risk groups, respectively. These rates were 100%, 92%, 70%, and 41% for clinical class I, II, III and IVa-b patients, respectively (Table 4; Figures 2, 3, 4 show the complete follow-up). The C-Indices for clinical classification in the training set and testing set were 0.742 and 0.733, respectively, while these values were 0.751 and 0.762 for the C-C model. These results confirmed that the C-C model was more precise in predicting the prognosis of NPC patients than clinical classification alone.

Bottom Line: Sex, age, histology, T classification, clinical classification and local recurrence were not associated with sCXCL5 levels.Furthermore, this novel model successfully divided the patients into four risk subgroups in the training set, the testing set and the entire set of patients.The novel statistical C-C model, which includes sCXCL5 levels and clinical classification, could be helpful in predicting the prognosis of NPC patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, Guangzhou, China.

ABSTRACT

Background: Aberrant expression of C-X-C motif chemokine 5 (CXCL5) contributes to the progression of various cancers. This study analyzed the clinical significance of serum CXCL5 (sCXCL5) levels of nasopharyngeal carcinoma (NPC) patients, with the goal of building a novel prognostic score model.

Experimental design: Serum samples were collected prior to treatment from 290 NPC patients for the detection of sCXCL5 with ELISA. Half of the patients (n = 145) were randomly assigned to the training set to generate the sCXCL5 cutoff point using receiver operator characteristic (ROC) analysis, while the other half (n = 145) were assigned to the testing set for validation. Associations between sCXCL5 levels and clinical characteristics were analyzed. A prognostic score model was built using independent predictors derived from multivariate analysis. A concordance index (C-Index) was used to evaluate prognostic ability.

Results: The sCXCL5 cutoff point was 0.805 ng/ml. Sex, age, histology, T classification, clinical classification and local recurrence were not associated with sCXCL5 levels. However, sCXCL5 levels were positively associated with N classification, distant metastasis and disease progression (P<0.05). A high sCXCL5 level predicted poor 6-year overall survival (OS), poor 6-year distant metastasis-free survival (DMFS), and poor 6-year progression-free survival (PFS). A prognostic score model was subsequently constructed based on sCXCL5 levels and clinical classification (C-C model), which are independent predictors of OS, DMFS, and PFS, as confirmed by the multivariate analysis. Furthermore, this novel model successfully divided the patients into four risk subgroups in the training set, the testing set and the entire set of patients. The C-Indices were 0.751 and 0.762 for the training set and the testing set, respectively.

Conclusions: sCXCL5 level was determined to be an independent prognostic factor for NPC patients. The novel statistical C-C model, which includes sCXCL5 levels and clinical classification, could be helpful in predicting the prognosis of NPC patients.

Show MeSH
Related in: MedlinePlus