RESUMO
OBJECTIVES: The aim of this study was to investigate the relationship between a comprehensive nutritional index (CNI) and QoL in patients with NPC who undergo IMRT and to explore the relationship between CNI and survival. METHODS: 359 patients with newly diagnosed NPC were enrolled. QoL was assessed with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core-30 and Quality of Life Questionnaire Head and Neck Cancer Module at three time points: before, immediately after, and 3â¯months after IMRT. The CNI comprised five values including body mass index, usual body weight percentage, hemoglobin, albumin, and total lymphocyte count, and was evaluated before and immediately after IMRT. The correlation between the CNI and QoL and the effect of CNI on prognosis were analysed. RESULTS: QoL and CNI scores decreased remarkably after IMRT (Pâ¯<â¯0.05). The CNI was quite low in patients with III-IV clinical tumor stage and those undergoing induction chemotherapy plus concurrent chemotherapy. After IMRT, lower CNI score correlated worse QoL (Pâ¯<â¯0.05). The Kaplan-Meier curve indicated that patients with lower CNI had significantly poorer survival outcomes (Pâ¯=â¯0.02). In multivariate analysis, CNI remained an independent prognostic factor of overall survival (Pâ¯=â¯0.046). CONCLUSIONS: CNI can be recommended as an appropriate indicator reflecting the integrated nutrition status of NPC patients. Low CNI was associated with poor QoL and predicted a poor survival outcome. More interventions should be taken to improve the nutrition status of NPC patients to improve QoL and enhance survival outcomes.
Assuntos
Carcinoma Nasofaríngeo/epidemiologia , Neoplasias Nasofaríngeas/epidemiologia , Estado Nutricional , Qualidade de Vida , Adolescente , Adulto , Idoso , Feminino , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Carcinoma Nasofaríngeo/mortalidade , Carcinoma Nasofaríngeo/patologia , Carcinoma Nasofaríngeo/radioterapia , Neoplasias Nasofaríngeas/mortalidade , Neoplasias Nasofaríngeas/patologia , Neoplasias Nasofaríngeas/radioterapia , Avaliação Nutricional , Prognóstico , Vigilância em Saúde Pública , Radioterapia de Intensidade Modulada , Inquéritos e Questionários , Resultado do Tratamento , Adulto JovemRESUMO
Previous studies have determined that activated hepatic stellate cells (aHSCs) promote the progression of hepatocellular carcinoma (HCC) by increasing angiogenesis in cancerous tissues. In addition, angiopoietin 1 (Ang1) has been reported to be involved in tumor growth and metastasis via the promotion of angiogenesis. It remains unclear whether aHSCs and Ang1 are involved in the angiogenesis in HCC. A total of 25 HCC and tumoradjacent tissues, and 21 normal liver tissues were used in the present study. Immunohistochemistry (IHC) was used to detect the expression of Ang1 and α smooth muscle actin (αSMA). The expression of CD34 was also analyzed using IHC to evaluate the microvessel density (MVD). The protein expression levels of Ang1 were evaluated using western blot analysis. The association between aHSC, Ang1 and angiogenesis was determined using Spearman's rank correlation coefficient. The present study determined that the expression of αSMA, Ang1 and MVD (CD34) was significantly higher in the HCC tissues when compared with tumoradjacent tissues and normal liver tissues. Spearman's rank analysis identified a positive correlation between the expression of αSMA, Ang1 and CD34. This suggests that αSMApositive aHSCs promoted angiogenesis by expressing Ang1, resulting in the proliferation and metastasis of HCC.