Favorable prognosis of female patients with nasopharyngeal carcinoma.

The female sex is traditionally considered a favorable prognostic factor for nasopharyngeal carcinoma (NPC). However, no particular study has reported this phenomenon. To explore the prognostic impact of gender on patients with NPC after definitive radiotherapy, we reviewed the clinical data of 2063 consecutive patients treated between 1st January 2000 and 31st December 2003 in the Sun Yat-sen University Cancer Center. The median follow-up for the whole series was 81 months. The female and male patients with early stage disease comprised 49.4% and 28.1% of the patient population, respectively. Both the 5-year overall survival (OS) and disease-specific survival (DSS) rates of female patients were significantly higher than those of male patients (OS: 79% vs. 69%, P < 0.001; DSS: 81% vs. 70%, P < 0.001). For patients with locoregionally advanced NPC, the 5-year OS and DSS rates of female vs. male patients were 74% vs. 63% (P < 0.001) and 76% vs. 64%, respectively (P < 0.001). A multivariate analysis showed that gender, age, and TNM stage were independent prognostic factors for the 5-year OS and DSS of NPC patients. The favorable prognosis of female patients is not only attributed to the early diagnosis and treatment but might also be attributed to some intrinsic factors of female patients.

Serum CCL2 and serum TNF-α--two new biomarkers predict bone invasion, post-treatment distant metastasis and poor overall survival in nasopharyngeal carcinoma.

PURPOSE: To evaluate the prognostic potential of serum CCL2 (sCCL2) and serum TNF-α (sTNF-α) in nasopharyngeal carcinoma (NPC) before treatment by analysing the expression of these two markers. EXPERIMENTAL DESIGN: Both sCCL2 and sTNF-α were prospectively detected in 297 NPC patients with enzyme-linked immunosorbent assay (ELISA) before treatment. The correlations between sCCL2 level or sTNF-α level and patient's survival were evaluated. RESULTS: For sCCL2, the 5-year overall survival (OS) and 5-year distant metastasis-free survival (DMFS) of high expression group and low expression group were 64% versus 81% and 67% versus 84% (P < 0.05), respectively. For sTNF-α, the 5-year OS and 5-year DMFS of high expression group and low expression group were 62% versus 79% and 66% versus 82% (P < 0.05), respectively. The 5-year OS and 5-year DMFS for both positive patients, one marker positive patient and both negative patients were 53% versus 77% versus 85% and 58% versus 80% versus 86% (P < 0.05), respectively. Concentrations of sCCL2 and sTNF-α in patients with large skull base invasion were higher than those without or with small skull invasion (P < 0.05). Patients who developed bone metastasis alone after radical treatment had higher pre-treatment concentrations of sCCL2 and sTNF-α than those without metastasis (P < 0.001). Multifactorial Cox regression analyses demonstrated that T/N/M classification, chemotherapy, sCCL2 level and sTNF-α level were independent predictors of OS and DMFS of NPC patients. CONCLUSION: High expression levels of sCCL2 and sTNF-α predict bone invasion, post-treatment distant metastasis and poor overall survival in NPC patients.

Expression and clinical significance of Wnt-1 and beta-catenin in nasopharyngeal carcinoma.

BACKGROUND AND OBJECTIVE: As signaling molecule and key component of Wnt/beta-catenin signaling pathway respectively, Wnt-1 and beta-catenin are abnormally expressed in several malignancies and correlate with poor prognosis. This study was to investigate the expression and clinical significance of Wnt-1 and beta-catenin in nasopharyngeal carcinoma (NPC). METHODS: The expression of Wnt-1 and beta-catenin in 111 specimens of NPC was detected by SP immunohistochemistry. Their correlations to relapse-free survival (RFS), metastasis-free survival (MFS) and progression-free survival (PFS) were analyzed. RESULTS: The high expression of beta-catenin was observed in 64 (57.7%) of the 111 cases. Its high expression rate was significantly higher in advanced NPC than in early stage NPC (63.1% vs. 40.7%, p = 0.041). The RFS, MFS and PFS were lower in high beta-catenin expression group than in low beta-catenin expression group (p < 0.05). Cox regression analysis demonstrated that beta-catenin was related to poor prognosis of NPC patients. The high expression of Wnt-1 was observed in 68 (61.3%) of the 111 cases, but its expression had no effect on RFS, MFS and PFS (p > 0.05). CONCLUSIONS: Wnt/beta-catenin signaling pathway may be activated abnormally in some NPC patients. beta-catenin may be a prognostic factor of NPC.