鼻咽癌新辅助化疗疗效预测模型的建立

发布时间：2018-04-30 11:29

本文选题：鼻咽肿瘤 + 新辅助化疗　；参考：《重庆医学》2014年32期

【摘要】：目的建立鼻咽癌新辅助化疗近期疗效的模型,为个体化治疗提供依据。方法对鼻咽癌新辅助化疗的63例患者的临床资料进行回顾性分析,在综合分析影响疗效主要因素的基础上,采用Logistic回归分析构建预测模型。结果新辅助化疗鼻咽部病灶有效率为39.7%,颈部淋巴结转移灶有效率为50.8%。单因素分析显示,无远处转移、颅神经未受侵犯、血浆EBV阴性、Ki67高表达的患者对治疗更敏感。逐步Logistic回归分析显示,远处转移、颅神经受侵、血浆EBV情况影响新辅助化疗疗效。由此建立的预测模型为:Logit=-0.470-2.863×远处转移+1.328×颅神经受侵+3.639×EBV,其预测的灵敏度为79.4%,特异性为82.8%,阳性预测值为84.4%,阴性预测值为77.4%。结论远处转移、颅神经受侵情况和EBV感染是影响晚期鼻咽癌患者新辅助化疗疗效的重要指标,由此建立的预测模型为鼻咽癌患者个体化治疗提供初步的依据。
[Abstract]:Objective to establish a model of neo-adjuvant chemotherapy for nasopharyngeal carcinoma (NPC) and provide evidence for individualized treatment. Methods the clinical data of 63 patients with nasopharyngeal carcinoma treated with neoadjuvant chemotherapy were retrospectively analyzed. Based on the comprehensive analysis of the main factors affecting the curative effect, the prediction model was constructed by Logistic regression analysis. Results the effective rate of neoadjuvant chemotherapy was 39.7% for nasopharyngeal lesions and 50.8% for cervical lymph node metastasis. Univariate analysis showed that patients with no distant metastasis, no cranial nerve invasion and high expression of plasma EBV negative Ki67 were more sensitive to treatment. Stepwise Logistic regression analysis showed that distant metastasis, cranial nerve invasion and plasma EBV affected the efficacy of neoadjuvant chemotherapy. The prediction model was established as follows: 0. 470-2. 863 脳 distant metastasis 1.328 脳 cranial nerve invasion 3.639 脳 EBV. The predictive sensitivity was 79. 4%, the specificity was 82. 8%, the positive predictive value was 84. 4%, and the negative predictive value was 77. 4%. Conclusion distant metastasis, cranial nerve invasion and EBV infection are important indexes to influence the efficacy of neoadjuvant chemotherapy in patients with advanced nasopharyngeal carcinoma.
【作者单位】：第三军医大学大坪医院野战外科研究所肿瘤中心;重庆市江津区中心医院肿瘤科;
【基金】：国家自然科学基金资助项目(81272498)
【分类号】：R739.63

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