Pretreatment Serum Amyloid A and C-reactive Protein Comparing with Epstein-Barr Virus DNA as Prognostic Indicators in Patients with Nasopharyngeal Carcinoma: A Prospective Study.
Purpose
The measuring Epstein-Barr virus (EBV) DNA is an important predictor of nasopharyngeal carcinoma (NPC). This study evaluated the predictive value of pretreatment serum amyloid A (SAA) and C-reactive protein (CRP) comparing with EBV DNA in patients with NPC.


Materials and Methods
In an observational study of 419 non-metastatic NPC patients, we prospectively evaluated the prognostic effects of pretreatment SAA, CRP, and EBV DNA on survival. The primary endpoint was progress-free survival (PFS).


Results
The median level of SAA and CRP was 4.28 mg/L and 1.88 mg/L, respectively. For the highSAA group (&gt; 4.28 mg/L) versus the low-SAA (≤ 4.28 mg/L) group and the high-CRP group (&gt; 1.88 mg/L) versus the low-CRP (≤ 1.88 mg/L) group, the 5-year PFS was 64.5% versus 73.1% (p=0.013) and 65.2% versus 73.3% (p=0.064), respectively. EBV DNA detection showed a superior predictive result, the 5-year PFS in the EBV DNA ≥ 1,500 copies/mL group was obviously different than the EBV DNA &lt; 1,500 copies/mL group (62.2% versus 77.8%, p &lt; 0.001). Multifactorial Cox regression analysis confirmed that in the PFS, the independent prognostic factors were including EBV DNA (hazard ratio [HR], 1.788; p=0.009), tumour stage (HR, 1.903; p=0.021), and node stage (HR, 1.498; p=0.049), but the SAA and CRP were not included in the independent prognostic factors.


Conclusion
The results of SAA and CRP had a certain relationship with the prognosis of NPC, and the prognosis of patients with high level of SAA and CRP were poor. However, the predictive ability of SAA and CRP was lower than that of EBV DNA.
['Chen|Qiu-Yan|QY|', 'Tang|Qing-Nan|QN|', 'Tang|Lin-Quan|LQ|', 'Chen|Wen-Hui|WH|', 'Guo|Shan-Shan|SS|', 'Liu|Li-Ting|LT|', 'Li|Chao-Feng|CF|', 'Li|Yang|Y|', 'Liang|Yu-Jing|YJ|', 'Sun|Xue-Song|XS|', 'Guo|Ling|L|', 'Mo|Hao-Yuan|HY|', 'Sun|Rui|R|', 'Luo|Dong-Hua|DH|', 'Fan|Yu-Ying|YY|', 'He|Yan|Y|', 'Chen|Ming-Yuan|MY|', 'Cao|Ka-Jia|KJ|', 'Qian|Chao-Nan|CN|', 'Guo|Xiang|X|', 'Mai|Hai-Qiang|HQ|']
D000328:Adult D000368:Aged D000369:Aged, 80 and over D002097:C-Reactive Protein D002277:Carcinoma D004279:DNA, Viral D020031:Epstein-Barr Virus Infections D005260:Female D004854:Herpesvirus 4, Human D006801:Humans D008297:Male D008875:Middle Aged D000077274:Nasopharyngeal Carcinoma D009303:Nasopharyngeal Neoplasms D009367:Neoplasm Staging D011379:Prognosis D011446:Prospective Studies D000685:Serum Amyloid A Protein D055815:Young Adult
Serum amyloid A C-reactive protein Epstein-Barr virus Nasopharyngeal carcinoma Prognosis Survival analysis