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Chiang CL, Guo Q, Ng WT, Lin S, Ma TSW, Xu Z, Xiao Y, Li J, Lu T, Choi HCW, Chen W, Chau ESC, Luk PHY, Huang SH, O'Sullivan B, Pan J, Lee AWM. Prognostic Factors for Overall Survival in Nasopharyngeal Cancer and Implication for TNM Staging by UICC: A Systematic Review of the Literature. Front Oncol 2021; 11:703995. [PMID: 34540670 PMCID: PMC8445029 DOI: 10.3389/fonc.2021.703995] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Accepted: 07/29/2021] [Indexed: 12/14/2022] Open
Abstract
This study aims to identify prognostic factors in nasopharyngeal carcinoma (NPC) to improve the current 8th edition TNM classification. A systematic review of the literature reported between 2013 and 2019 in PubMed, Embase, and Scopus was conducted. Studies were included if (1) original clinical studies, (2) ≥50 NPC patients, and (3) analyses on the association between prognostic factors and overall survival. The data elements of eligible studies were abstracted and analyzed. A level of evidence was synthesized for each suggested change to the TNM staging and prognostic factors. Of 5,595 studies screened, 108 studies (44 studies on anatomical criteria and 64 on non-anatomical factors) were selected. Proposed changes/factors with strong evidence included the upstaging paranasal sinus to T4, defining parotid lymph node as N3, upstaging N-category based on presence of lymph node necrosis, as well as the incorporation of non-TNM factors including EBV-DNA level, primary gross tumor volume (GTV), nodal GTV, neutrophil-lymphocyte ratio, lactate dehydrogenase, C-reactive protein/albumin ratio, platelet count, SUVmax of the primary tumor, and total lesion glycolysis. This systematic review provides a useful summary of suggestions and prognostic factors that potentially improve the current staging system. Further validation studies are warranted to confirm their significance.
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Affiliation(s)
- Chi Leung Chiang
- Clinical Oncology Center, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China.,Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - Qiaojuan Guo
- Department of Radiation Oncology, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou, China
| | - Wai Tong Ng
- Clinical Oncology Center, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China.,Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - Shaojun Lin
- Department of Radiation Oncology, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou, China
| | - Tiffany Sze Wai Ma
- Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - Zhiyuan Xu
- Clinical Oncology Center, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Youping Xiao
- Department of Radiation Oncology, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou, China
| | - Jishi Li
- Clinical Oncology Center, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Tianzhu Lu
- Department of Radiation Oncology, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou, China
| | - Horace Cheuk Wai Choi
- Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - Wenqi Chen
- Clinical Oncology Center, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Eric Sze Chun Chau
- Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - Peter Ho Yin Luk
- Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - Shao Hui Huang
- Department of Radiation Oncology, University of Toronto, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Brian O'Sullivan
- Department of Radiation Oncology, University of Toronto, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Jianji Pan
- Department of Radiation Oncology, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou, China
| | - Anne Wing Mui Lee
- Clinical Oncology Center, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China.,Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
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Uehara T, Doi H, Ishikawa K, Inada M, Tatsuno S, Wada Y, Oguma Y, Kawakami H, Nakamatsu K, Hosono M, Nishimura Y. Serum lactate dehydrogenase is a predictive biomarker in patients with oropharyngeal cancer undergoing radiotherapy: Retrospective study on predictive factors. Head Neck 2021; 43:3132-3141. [PMID: 34268826 PMCID: PMC8457164 DOI: 10.1002/hed.26814] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 05/08/2021] [Accepted: 07/07/2021] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND The present study aimed to evaluate the prognostic factors in human papillomavirus (HPV)-positive and HPV-negative oropharyngeal cancer (OPC) treated with definitive radiotherapy. METHODS We retrospectively evaluated 101 patients with OPC who underwent definitive radiotherapy between 2008 and 2018. RESULTS The median follow-up period of the surviving patients was 68 months (range, 8-164 months). The 5-year overall survival rate was 69.8%. Univariate analyses revealed that poor survival was associated with male sex, smoking ≥30 pack-years, Eastern Cooperative Oncology Group performance status ≥1, tumor-node-metastasis (TNM) stage III-IV (8th edition), HPV-negativity, serum lactate dehydrogenase (LDH) ≥202, C-reactive protein/albumin ratio ≥0.15, and lymphocyte-to-monocyte ratio <2.90. In multivariate analyses, poor survival was independently correlated with smoking ≥30 pack-years (p < 0.01) and LDH ≥202 (p = 0.02). CONCLUSIONS The present study suggested that high LDH levels predicted poor survival after definitive radiotherapy for patients with both HPV-positive and HPV-negative OPC.
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Affiliation(s)
- Takuya Uehara
- Department of Radiation Oncology, Faculty of MedicineKindai UniversityOsakasayamaJapan
| | - Hiroshi Doi
- Department of Radiation Oncology, Faculty of MedicineKindai UniversityOsakasayamaJapan
| | - Kazuki Ishikawa
- Department of Radiation Oncology, Faculty of MedicineKindai UniversityOsakasayamaJapan
| | - Masahiro Inada
- Department of Radiation Oncology, Faculty of MedicineKindai UniversityOsakasayamaJapan
| | - Saori Tatsuno
- Department of Radiation Oncology, Faculty of MedicineKindai UniversityOsakasayamaJapan
| | - Yutaro Wada
- Department of Radiation Oncology, Faculty of MedicineKindai UniversityOsakasayamaJapan
| | - Yasuo Oguma
- Department of Radiation Oncology, Faculty of MedicineKindai UniversityOsakasayamaJapan
| | - Hisato Kawakami
- Department of Medical Oncology, Faculty of MedicineKindai UniversityOsakasayamaJapan
| | - Kiyoshi Nakamatsu
- Department of Radiation Oncology, Faculty of MedicineKindai UniversityOsakasayamaJapan
| | - Makoto Hosono
- Department of Radiation Oncology, Faculty of MedicineKindai UniversityOsakasayamaJapan
| | - Yasumasa Nishimura
- Department of Radiation Oncology, Faculty of MedicineKindai UniversityOsakasayamaJapan
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Wang H, Shan D, Dong Y, Yang X, Zhang L, Yu Z. Correlation analysis of serum cystatin C, uric acid and lactate dehydrogenase levels before chemotherapy on the prognosis of small-cell lung cancer. Oncol Lett 2020; 21:73. [PMID: 33365084 PMCID: PMC7716718 DOI: 10.3892/ol.2020.12334] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Accepted: 10/26/2020] [Indexed: 12/14/2022] Open
Abstract
Related studies have reported that cystatin C (Cys C), uric acid (UA) and lactate dehydrogenase (LDH) affect tumor growth and invasion; however, the correlation between them and the prognosis of patients with small-cell lung cancer (SCLC) remains unclear. The present study aimed to investigate the effects of serum Cys C, UA and LDH concentrations on the prognosis of patients with SCLC prior to initial treatment, in order to identify potential targets for determining the clinical outcome of patients with SCLC. A total of 205 patients with SCLC were enrolled in the present study, and the clinical and laboratory data were obtained from the medical records. The receiver operating characteristic curve was used to determine the optimal cut-off values of Cys C, UA and LDH, while the Kaplan-Meier method was used for survival analysis. The Cox proportional hazard model was used for univariate and multivariate analyses to identify independent prognostic factors. The optimal cut-off values for Cys C, UA and LDH were 0.775 mg/l, 296.45 µmol/l and 198.5 U/l, respectively. The survival curves demonstrated that progression-free survival (PFS) and overall survival (OS) time were shorter in patients with high levels of Cys C, UA and LDH prior to chemotherapy. Univariate and multivariate analyses indicated that LDH concentration prior to chemotherapy may be an independent prognostic factor for both PFS and OS in patients with SCLC, while Cys C concentration may be an independent prognostic factor for PFS in patients with SCLC. The concentrations of Cys C, UA and LDH prior to chemotherapy were associated with prognosis of patients with SCLC. PFS and OS time were shorter, and the prognosis was poor in patients with elevated serum levels of Cys C, UA and LDH. Taken together, the results of the present study suggest that high concentrations of LDH and Cys C prior to chemotherapy may indicate rapid disease progression, thus it is important to focus on the progression and recurrence of the disease. High LDH concentration may also indicate a shorter survival time.
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Affiliation(s)
- Haocheng Wang
- Department of Oncology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, P.R. China
| | - Dongfeng Shan
- Department of Oncology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, P.R. China
| | - Ya Dong
- Department of Oncology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, P.R. China
| | - Xue Yang
- Department of Oncology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, P.R. China
| | - Linwei Zhang
- Department of Oncology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, P.R. China
| | - Zhuang Yu
- Department of Oncology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, P.R. China
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Yang J, Hu J, Wang D, Jia Q, Jiao J, Xiao J. Surgical Treatment Outcomes of Spinal Metastases of Nasopharyngeal Carcinoma: The First Report of 30 Patients from a Single Center. Cancer Manag Res 2020; 12:6999-7008. [PMID: 32821166 PMCID: PMC7418175 DOI: 10.2147/cmar.s257685] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 07/15/2020] [Indexed: 12/12/2022] Open
Abstract
Background Studies focused on surgical interventions of spinal metastases of nasopharyngeal carcinoma (SMNPC) are blank. Methods Patients with SMNPC who received surgical treatment in our center between 2005 and 2017 were included. Univariate and multivariate analysis of various clinical characteristics and operation-related data were analyzed to identify the independent factors that affected prognosis. Factors with P values of 0.1 or less were subjected to multivariate Cox regression analysis. P values of 0.05 or less were considered statistically significant. Results A total of 30 patients with SMNPC treated with surgery were included. The thoracic spine was the most frequently involved site. The patients in this series achieved good overall survival (OS, 20.26 months) with limited perioperative complications. The univariate analysis suggested that preoperative Karnofsky performance scale, number of spinal metastases, number of visceral metastases, preoperative Frankel score, surgical resection mode and Ki 67 were potential prognostic factors. In the multivariate analyses, number of visceral metastases, preoperative Frankel score and resection mode were found to be independent prognostic factors. Conclusion This is the first study focusing on surgical outcomes in SMNPC. The thoracic spine was the most frequently involved site of SMNPC. Preoperative Frankel score, number of visceral metastasis and surgical resection mode were independent prognostic factors for SMNPC. Combined with adjuvant therapies, surgical interventions should be recommended early when necessary.
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Affiliation(s)
- Jian Yang
- Department of Orthopedic Oncology, Changzheng Hospital, Navy Medical University, Shanghai, People's Republic of China
| | - Jinbo Hu
- Department of Orthopedic Oncology, Changzheng Hospital, Navy Medical University, Shanghai, People's Republic of China
| | - Da Wang
- Department of Orthopedic Oncology, Changzheng Hospital, Navy Medical University, Shanghai, People's Republic of China
| | - Qi Jia
- Department of Orthopedic Oncology, Changzheng Hospital, Navy Medical University, Shanghai, People's Republic of China
| | - Jian Jiao
- Department of Orthopedic Oncology, Changzheng Hospital, Navy Medical University, Shanghai, People's Republic of China
| | - Jianru Xiao
- Department of Orthopedic Oncology, Changzheng Hospital, Navy Medical University, Shanghai, People's Republic of China
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Chen J, Liu T, Sun Q, Jin T. Comparison of the efficacy between concurrent chemoradiotherapy with or without adjuvant chemotherapy for stage II nasopharyngeal carcinoma. Medicine (Baltimore) 2020; 99:e20443. [PMID: 32702809 PMCID: PMC7373555 DOI: 10.1097/md.0000000000020443] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Although common, the use of concurrent chemoradiotherapy with adjuvant chemotherapy for stage II nasopharyngeal carcinoma (NPC) is controversial due to its undefined clinical benefits. We, therefore, conducted a retrospective cohort study to investigate whether adjuvant chemotherapy confers survival gains to stage II NPC patients. METHODS In this study, we examined whether combining adjuvant chemotherapy (AC) and/or concurrent chemotherapy with radiotherapy (CCRT) improved survival in patients with stage II NPC. Three hundred thirty-five stage II NPC patients were retrospectively analyzed between June 2003 and June 2016 and received CCRT; some patient groups also received AC every 3 weeks for 2 to 3 cycles. RESULTS The median follow-up duration was 72 months for all patients (range, 26-151 months) and the estimated 5-year locoregional relapse-free survival (LRRFS), distant metastasis-free survival (DMFS), progression-free survival (PFS), and overall survival (OS) rates were 95.1%, 97.8%, 93.5%, and 94.3%. At the last follow-up, there were no statistically significant differences among the CCRT and CCRT+AC groups in 5-year LRRFS (95.2% vs 94.9%, P = .599), DMFS (98.5% vs 92.4%, P = .152), PFS (93.8% vs 90.2%, P = .599), or OS (95.5% vs 93.9%, P = .682) rates. CONCLUSION The analyses revealed that a combined regimen was not an independent prognostic factor for any survival outcome. However, patients who received CCRT plus AC experienced more acute adverse events than those who received CCRT alone. Thus, the addition of AC to CCRT did not improve survival outcomes, but was associated with higher incidences of acute treatment-associated toxicities than CCRT alone in patients with stage II NPC.
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Affiliation(s)
- Jing Chen
- Institute of Cancer and Basic Medicine, Chinese Academy of Sciences
- Department of Radiation Oncology, Cancer Hospital of the University of Chinese Academy of Sciences
- Department of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province, China
| | - Tongxin Liu
- Institute of Cancer and Basic Medicine, Chinese Academy of Sciences
- Department of Radiation Oncology, Cancer Hospital of the University of Chinese Academy of Sciences
- Department of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province, China
| | - Quanquan Sun
- Institute of Cancer and Basic Medicine, Chinese Academy of Sciences
- Department of Radiation Oncology, Cancer Hospital of the University of Chinese Academy of Sciences
- Department of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province, China
| | - Ting Jin
- Institute of Cancer and Basic Medicine, Chinese Academy of Sciences
- Department of Radiation Oncology, Cancer Hospital of the University of Chinese Academy of Sciences
- Department of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province, China
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Lactate Dehydrogenases as Metabolic Links between Tumor and Stroma in the Tumor Microenvironment. Cancers (Basel) 2019; 11:cancers11060750. [PMID: 31146503 PMCID: PMC6627402 DOI: 10.3390/cancers11060750] [Citation(s) in RCA: 151] [Impact Index Per Article: 30.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 05/20/2019] [Accepted: 05/23/2019] [Indexed: 02/07/2023] Open
Abstract
Cancer is a metabolic disease in which abnormally proliferating cancer cells rewire metabolic pathways in the tumor microenvironment (TME). Molecular reprogramming in the TME helps cancer cells to fulfill elevated metabolic demands for bioenergetics and cellular biosynthesis. One of the ways through which cancer cell achieve this is by regulating the expression of metabolic enzymes. Lactate dehydrogenase (LDH) is the primary metabolic enzyme that converts pyruvate to lactate and vice versa. LDH also plays a significant role in regulating nutrient exchange between tumor and stroma. Thus, targeting human lactate dehydrogenase for treating advanced carcinomas may be of benefit. LDHA and LDHB, two isoenzymes of LDH, participate in tumor stroma metabolic interaction and exchange of metabolic fuel and thus could serve as potential anticancer drug targets. This article reviews recent research discussing the roles of lactate dehydrogenase in cancer metabolism. As molecular regulation of LDHA and LDHB in different cancer remains obscure, we also review signaling pathways regulating LDHA and LDHB expression. We highlight on the role of small molecule inhibitors in targeting LDH activity and we emphasize the development of safer and more effective LDH inhibitors. We trust that this review will also generate interest in designing combination therapies based on LDH inhibition, with LDHA being targeted in tumors and LDHB in stromal cells for better treatment outcome.
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Xu C, Sun R, Tang LL, Chen L, Li WF, Mao YP, Zhou GQ, Guo R, Lin AH, Sun Y, Ma J, Hu WH. Role of sequential chemoradiotherapy in stage II and low-risk stage III-IV nasopharyngeal carcinoma in the era of intensity-modulated radiotherapy: A propensity score-matched analysis. Oral Oncol 2018; 78:37-45. [PMID: 29496056 DOI: 10.1016/j.oraloncology.2018.01.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 12/30/2017] [Accepted: 01/14/2018] [Indexed: 02/07/2023]
Abstract
OBJECTIVES To investigate the role of sequential chemoradiotherapy (SCRT; induction chemotherapy [IC] followed by intensity-modulated radiotherapy [IMRT]) in stage II and low-risk stage III-IV nasopharyngeal carcinoma (NPC). MATERIALS AND METHODS Four well-matched groups were individually generated using propensity score matching in patients (n = 689) with stage II (SCRT vs. concurrent chemoradiotherapy [CCRT], SCRT vs. IMRT alone) and low-risk stage III-IV NPC (SCRT vs. CCRT, SCRT vs. IC + CCRT). Five-year overall/disease-free/locoregional relapse-free/distant metastasis-free survival (OS/DFS/LRRFS/DMFS) and acute hematological toxicities were compared between groups. The value of SCRT was further investigated in multivariate analysis and subgroup analysis by adjusting for covariates and limiting IC-to-IMRT time interval, respectively. RESULTS SCRT led to equivalent survival outcomes compared to CCRT/IMRT alone and CCRT/IC + CCRT in stage II and low-risk stage III-IV NPC, respectively (all P > .050). In multivariate analysis, patients with stage II NPC treated by SCRT obtained higher DMFS (AHR = 0.22, 95% CI = 0.05-1.00, P = .050), but not OS, DFS or LRRFS, compared to patients receiving CCRT; non-significant differences were observed between SCRT and other treatments. SCRT with short IC-to-IMRT time interval (≤70 days) achieved higher 5-year survival rates than IMRT alone (DMFS: P = .046), CCRT (stage II NPC; OS: P = .047; DMFS: P = .020) and IC + CCRT (DFS: P = .041). Moreover, SCRT was associated with higher, equivalent and lower frequencies of acute hematological toxicities than IMRT alone, CCRT and IC + CCRT, respectively. CONCLUSION SCRT is mainly beneficial in stage II NPC, leading to better DMFS and/or equivalent acute hematological toxicities compared to CCRT/IMRT alone. CCRT is still the best choice for low-risk stage III-IV NPC.
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Affiliation(s)
- Cheng Xu
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, People's Republic of China
| | - Rui Sun
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, People's Republic of China
| | - Ling-Long Tang
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, People's Republic of China
| | - Lei Chen
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, People's Republic of China
| | - Wen-Fei Li
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, People's Republic of China
| | - Yan-Ping Mao
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, People's Republic of China
| | - Guan-Qun Zhou
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, People's Republic of China
| | - Rui Guo
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, People's Republic of China
| | - Ai-Hua Lin
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Ying Sun
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, People's Republic of China
| | - Jun Ma
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, People's Republic of China.
| | - Wei-Han Hu
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, People's Republic of China.
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MiR-34b-3 and miR-449a inhibit malignant progression of nasopharyngeal carcinoma by targeting lactate dehydrogenase A. Oncotarget 2018; 7:54838-54851. [PMID: 27458165 PMCID: PMC5342385 DOI: 10.18632/oncotarget.10761] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Accepted: 07/06/2016] [Indexed: 12/19/2022] Open
Abstract
MicroRNA expression profiling assays have shown that miR-34b/c and miR-449a are down-regulated in nasopharyngeal carcinoma (NPC); however, the targets and functions of miR-34b/c and miR-449a in the pathologenesis of NPC remain elusive. In this study, we verified miR-34b/c and miR-449a were significantly reduced with the advance of NPC. Overexpression of miR-34b-3 and miR-449a suppressed the growth of NPC cells in culture and mouse tumor xenografts. Using tandem mass tags for quantitative labeling and LC-MS/MS analysis to investigate protein changes after restoring expression of miR-34b-3, 251 proteins were found to be down-regulated after miR-34b-3 transfection. Through 3 replicate experiments, we found that miR-34b-3 regulated the expression of 15 potential targeted genes mainly clustered in the key enzymes of glycolysis metabolism, including lactate dehydrogenase A (LDHA). Further investigation revealed that miR-34b-3 and miR-449a negatively regulated LDHA by binding to the 3′ untranslated regions of LDHA. Furthermore, LDHA overexpression rescued the miR-34b-3 and miR-449a induced tumor inhibition effect in CNE2 cells. In addition, miR-34b-3 and miR-449a suppressed LDH activity and reduced LD content, which were directly induced by downregulation of the LDHA. Our findings suggest that miR-34b-3 and miR-449a suppress the development of NPC through regulation of glycolysis via targeting LDHA and may be potential therapeutic targets for the treatment of NPC.
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Wang J, Li L, Dong BQ, Xu YJ, Zheng YD, Sun ZW, Yang Y, Chen YY, Chen XZ, Chen M. Post-treatment serum lactic dehydrogenase as a predictive indicator for distant metastasis and survival of patients with nasopharyngeal carcinoma. Oncotarget 2018; 7:27458-67. [PMID: 27050275 PMCID: PMC5053663 DOI: 10.18632/oncotarget.8480] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 03/18/2016] [Indexed: 11/25/2022] Open
Abstract
Purpose To examine the function of serum lactic dehydrogenase (SLDH) level after intensity-modulated radiotherapy (IMRT) as a predictive factor for and loco-regional relapse free survival (LRFS), distant metastasis-free survival (DMFS), disease free survival (DFS), and overall survival(OS) among patients with in-situ nasopharyngeal carcinoma (NPC). Results Compared with the normal pt-SLDH group, elevated pt-SLDH demonstrated significant lower DMFS (46 versus 66 months, hazard ratio (HR) 4.07, 95% CI 2.43–6.80, p < 0.001), DFS (46 versus 63 months, HR 2.78, 95% CI 1.70–4.53, p < 0.001), and OS (54 versus 66 months, HR 2.93, 95% CI 1.65–5.23, p < 0.001). Distant metastasis were observed in 32.8% (20/61) patients with elevated pt-SLDH, and 8% (54/678) in normal SLDH (odds ratio (OR) 6.13, 95% CI 3.35–11.18, p < 0.001). COX regression showed that pt-SLDH was an independent prognostic factors for OS (HR 2.91, 95% CI 1.57–5.41, p < 0.001), DMFS (HR 4.21, 95% CI 2.51–7.07, p < 0.001), LRFS (HR 2.53, 95% CI 1.22–5.24, p < 0.001), and DFS (HR 2.81, 95% CI 1.72–4.59, p < 0.001). Materials and Methods The records of 739 in-situ NPC patients admitted to Zhejiang Cancer Hospital between January 2007 and May 2012 were retrospectively reviewed. The relationships between post-treatment SLDH (pt-SLDH) and LRFS, DMFS, DFS, and OS were analyzed. Conclusions Our finding indicated that elevated pt-SLDH could be a simple available prognostic indicator for distant metastasis and survival for in-situ NPC patients.
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Affiliation(s)
- Jin Wang
- Department of Radiation Oncology, Zhejiang Key Lab of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China
| | - Li Li
- Department of Ultrasonography, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China
| | - Bai-Qiang Dong
- Department of Radiation Oncology, Zhejiang Key Lab of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China
| | - Yu-Jin Xu
- Department of Radiation Oncology, Zhejiang Key Lab of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China
| | - Yuan-da Zheng
- Department of Radiation Oncology, Zhejiang Key Lab of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China
| | - Zhong-Wen Sun
- Department of Oncology, Jining First People's Hospital, Jining, People's Republic of China
| | - Yang Yang
- Department of Radiation Oncology, Zhejiang Key Lab of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China
| | - Yuan-Yuan Chen
- Department of Radiation Oncology, Zhejiang Key Lab of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China
| | - Xiao-Zhong Chen
- Department of Radiation Oncology, Zhejiang Key Lab of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China
| | - Ming Chen
- Department of Radiation Oncology, Zhejiang Key Lab of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China
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Chee J, Loh KS, Tham I, Ho F, Wong LC, Tan CS, Goh BC, Lim CM. Prognostic stratification of patients with metastatic nasopharyngeal carcinoma using a clinical and biochemical scoring system. J Cancer Res Clin Oncol 2017; 143:2563-2570. [PMID: 28849413 DOI: 10.1007/s00432-017-2496-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 08/07/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE Metastatic nasopharyngeal cancer (NPC) is known to have poor survival outcomes. Clinical and biochemical parameters may impact survival outcomes among patients with metastatic NPC and may be used for prognostication. METHODS One-hundred and fifty-eight patients with metastatic NPC treated at a single tertiary institution were analyzed retrospectively. Multivariate analysis was carried out on patients who were given disease control treatment (n = 135). A numerical score derived from the regression coefficients of each identified independent variable was used to create prognostic groups (PG). A p value of less than 0.05 was considered significant. RESULTS Independent negative prognostic factors included ECOG status >1, LDH level >580 U/L, hemoglobin level <12.0 g/dL and having more than one metastatic organ involvement. Three PGs were obtained: low risk (total score = 0), intermediate risk (1-2) and high risk (3-4). Median survivals of the 3 groups (low, intermediate and high risk) were 57.1, 18.1 and 8.0 months for the three different risk groups, respectively (p < 0.001). CONCLUSION Risk stratification of patients with metastatic nasopharyngeal cancer is possible using a prognostic scoring system based on clinical and biochemical parameters. Patients with low-risk score may achieve good metastatic survival and may benefit from additional therapy for disease control.
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Affiliation(s)
- Jeremy Chee
- Department of Otolaryngology-Head and Neck Surgery, National University Health System, 1E Kent Ridge Road, NUHS Tower Block Level 7, Singapore, 119228, Singapore
| | - Kwok Seng Loh
- Department of Otolaryngology-Head and Neck Surgery, National University Health System, 1E Kent Ridge Road, NUHS Tower Block Level 7, Singapore, 119228, Singapore
| | - Ivan Tham
- Department of Radiation Oncology, National University Health System, Singapore, Singapore
| | - Francis Ho
- Department of Radiation Oncology, National University Health System, Singapore, Singapore
| | - Lea Choung Wong
- Department of Radiation Oncology, National University Health System, Singapore, Singapore
| | - Chee Seng Tan
- Department of Medical Oncology, National University Health System, Singapore, Singapore
| | - Boon Cher Goh
- Department of Medical Oncology, National University Health System, Singapore, Singapore
| | - Chwee Ming Lim
- Department of Otolaryngology-Head and Neck Surgery, National University Health System, 1E Kent Ridge Road, NUHS Tower Block Level 7, Singapore, 119228, Singapore.
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11
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Establishing and applying nomograms based on the 8th edition of the UICC/AJCC staging system to select patients with nasopharyngeal carcinoma who benefit from induction chemotherapy plus concurrent chemoradiotherapy. Oral Oncol 2017; 69:99-107. [DOI: 10.1016/j.oraloncology.2017.04.015] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Revised: 04/12/2017] [Accepted: 04/23/2017] [Indexed: 11/23/2022]
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12
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Chen Z, Guo Q, Lu T, Lin S, Zong J, Zhan S, Xu L, Pan J. Pretreatment Serum Lactate Dehydrogenase Level as an Independent Prognostic Factor of Nasopharyngeal Carcinoma in the Intensity-Modulated Radiation Therapy Era. Med Sci Monit 2017; 23:437-445. [PMID: 28120819 PMCID: PMC5289097 DOI: 10.12659/msm.899531] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background The aims of this study were to analyze the prognostic value of baseline lactate dehydrogenase (LDH) among nasopharyngeal carcinoma (NPC) patients treated with intensity-modulated radiation therapy (IMRT), and to evaluate the potential application of LDH in monitoring treatment efficacy dynamically. Material/Methods From June 2005 to December 2010, 1188 patients with non-metastatic NPC who underwent IMRT with or without chemotherapy were reviewed. Univariate and multivariate analyses were performed to evaluate the predictive value of baseline LDH. Wilcoxon signed-rank test was used to analyze the difference between baseline and post-radiotherapy LDH, and to compare post-radiotherapy LDH with the LDH in cases of distant failure. Results Patients with elevated LDH had significant inferior survival rates, in terms of overall survival (70.0% vs. 83.2%, p=0.010), disease-specific survival (71.1% vs. 85.7%, p=0.002), and distant metastasis-free survival (71.1% vs. 83.4%, p=0.009), but not correlated with locoregional relapse-free survival (p=0.275) or progression-free survival (p=0.104). Subgroup analysis demonstrated that this predictive effect was more significant with advanced stage. Sixty-five post-radiotherapy LDH levels were available from the 90 patients with high LDH at initial diagnosis, and these levels fell in 65 patients, with 62 cases (95.4%) falling within the normal range. Of the 208 patients who experienced distant metastasis, 87 had an available LDH level at that time. Among them, 69 cases (79.3%) had an increased level compared with the post-radiotherapy LDH level. Conclusions Pretreatment LDH is a simple, cost-effective biomarker that could predict survival rates and might be used in individualized treatment. It is also a potential biomarker that might reflect tumor burden and be used to monitor therapy efficacy.
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Affiliation(s)
- Zhuhong Chen
- Department of Radiation Oncology, Fujian Provincial Cancer Hospital, Fuzhou, Fujian, China (mainland).,Provincial Clinical College, Fujian Medical University, Fuzhou, Fujian, China (mainland).,Fujian Provincial Key Laboratory of Translational Cancer Medicine, Fuzhou, Fujian, China (mainland)
| | - Qiaojuan Guo
- Department of Radiation Oncology, Fujian Provincial Cancer Hospital, Fuzhou, Fujian, China (mainland).,Provincial Clinical College, Fujian Medical University, Fuzhou, Fujian, China (mainland).,Fujian Provincial Key Laboratory of Translational Cancer Medicine, Fuzhou, Fujian, China (mainland)
| | - Tianzhu Lu
- Department of Radiation Oncology, Fujian Provincial Cancer Hospital, Fuzhou, Fujian, China (mainland).,Provincial Clinical College, Fujian Medical University, Fuzhou, Fujian, China (mainland).,Fujian Provincial Key Laboratory of Translational Cancer Medicine, Fuzhou, Fujian, China (mainland)
| | - Shaojun Lin
- Department of Radiation Oncology, Fujian Provincial Cancer Hospital, Fuzhou, Fujian, China (mainland).,Provincial Clinical College, Fujian Medical University, Fuzhou, Fujian, China (mainland).,Fujian Provincial Key Laboratory of Translational Cancer Medicine, Fuzhou, Fujian, China (mainland)
| | - Jingfeng Zong
- Department of Radiation Oncology, Fujian Provincial Cancer Hospital, Fuzhou, Fujian, China (mainland).,Provincial Clinical College, Fujian Medical University, Fuzhou, Fujian, China (mainland).,Fujian Provincial Key Laboratory of Translational Cancer Medicine, Fuzhou, Fujian, China (mainland)
| | - Shenghua Zhan
- Department of Radiation Oncology, Fujian Provincial Cancer Hospital, Fuzhou, Fujian, China (mainland).,Provincial Clinical College, Fujian Medical University, Fuzhou, Fujian, China (mainland).,Fujian Provincial Key Laboratory of Translational Cancer Medicine, Fuzhou, Fujian, China (mainland)
| | - Luying Xu
- Department of Radiation Oncology, Fujian Provincial Cancer Hospital, Fuzhou, Fujian, China (mainland).,Provincial Clinical College, Fujian Medical University, Fuzhou, Fujian, China (mainland).,Fujian Provincial Key Laboratory of Translational Cancer Medicine, Fuzhou, Fujian, China (mainland)
| | - Jianji Pan
- Department of Radiation Oncology, Fujian Provincial Cancer Hospital, Fuzhou, Fujian, China (mainland).,Provincial Clinical College, Fujian Medical University, Fuzhou, Fujian, China (mainland).,Fujian Provincial Key Laboratory of Translational Cancer Medicine, Fuzhou, Fujian, China (mainland)
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13
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Overall survival of cancer patients with serum lactate dehydrogenase greater than 1000 IU/L. Tumour Biol 2016; 37:14083-14088. [PMID: 27511116 PMCID: PMC5097084 DOI: 10.1007/s13277-016-5228-2] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Accepted: 07/15/2016] [Indexed: 12/22/2022] Open
Abstract
High level of serum lactate dehydrogenase (LDH) is a well-known poor prognostic factor in patients with malignancies. However, there was no data on overall survival (OS) in cancer patients with serum LDH level > 1000 IU/L, and the prognostic value of the changes in LDH over time for OS had not been reported. Clinical data of 311 cancer patients with metastatic disease with serum LDH >1000 IU/L (four times upper limit of normal) admitted consecutively to a single center were reviewed in this retrospective study. LDH level ranged from 1002 to 8235 U/L with a mean of 1689 U/L. The median OS was 1.7 months (95 % CI: 1.4–2.0). About half of patients (n = 163, 52 %) died within 2 months with the median OS of 0.5 months (95 % CI: 0.3–0.7). Only 173 patients were indicated for salvage treatment. Fifty-one patients’ serum LDH level decreased to normal at 2 months following chemotherapy; OS was significantly longer in these patients (22.6 months, 95 % CI: 10.9–34.3, p < 0.001) compared to those with persistently abnormal serum LDH at 2 months (4.0 months, 95 % CI: 3.4–4.6). The independent factors that increased the death risk were ECOG performance status 3–4 (HR: 2.05, 95 % CI: 1.42–2.97, p < 0.001), supportive care only (HR: 2.91, 95 % CI: 2.06–4.10, p < 0.001), and persistently abnormal serum LDH at 2 months (HR: 2.72, 95 % CI: 1.67–4.42, p < 0.001). In conclusion, serum LDH level > 1000 IU/L predicted a terminal stage in metastatic cancer patients. OS was significantly prolonged in patients indicated for effective palliative treatment and LDH level decreased to normal at 2 months.
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14
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Pan JJ, Ng WT, Zong JF, Lee SWM, Choi HCW, Chan LLK, Lin SJ, Guo QJ, Sze HCK, Chen YB, Xiao YP, Kan WK, O'Sullivan B, Xu W, Le QT, Glastonbury CM, Colevas AD, Weber RS, Lydiatt W, Shah JP, Lee AWM. Prognostic nomogram for refining the prognostication of the proposed 8th edition of the AJCC/UICC staging system for nasopharyngeal cancer in the era of intensity-modulated radiotherapy. Cancer 2016; 122:3307-3315. [PMID: 27434142 DOI: 10.1002/cncr.30198] [Citation(s) in RCA: 111] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 06/12/2016] [Accepted: 06/20/2016] [Indexed: 12/26/2022]
Abstract
BACKGROUND The objective of this study was to develop a nomogram for refining prognostication for patients with nondisseminated nasopharyngeal cancer (NPC) staged with the proposed 8th edition of the American Joint Committee on Cancer (AJCC)/Union for International Cancer Control (UICC) staging system. METHODS Consecutive patients who had been investigated with magnetic resonance imaging, staged with the proposed 8th edition of the AJCC/UICC staging system, and irradiated with intensity-modulated radiotherapy from June 2005 to December 2010 were analyzed. A cohort of 1197 patients treated at Fujian Provincial Cancer Hospital was used as the training set, and the results were validated with 412 patients from Pamela Youde Nethersole Eastern Hospital. Cox regression analyses were performed to identify significant prognostic factors for developing a nomogram to predict overall survival (OS). The discriminative ability was assessed with the concordance index (c-index). A recursive partitioning algorithm was applied to the survival scores of the combined set to categorize the patients into 3 risk groups. RESULTS A multivariate analysis showed that age, gross primary tumor volume, and lactate dehydrogenase were independent prognostic factors for OS in addition to the stage group. The OS nomogram based on all these factors had a statistically higher bias-corrected c-index than prognostication based on the stage group alone (0.712 vs 0.622, P <.01). These results were consistent for both the training cohort and the validation cohort. Patients with <135 points were categorized as low-risk, patients with 135 to <160 points were categorized as intermediate-risk, and patients with ≥160 points were categorized as high-risk. Their 5-year OS rates were 92%, 84%, and 58%, respectively. CONCLUSIONS The proposed nomogram could improve prognostication in comparison with the TNM stage group. This could aid in risk stratification for individual NPC patients. Cancer 2016;122:3307-3315. © 2016 American Cancer Society.
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Affiliation(s)
- Jian Ji Pan
- Department of Radiation Oncology, Fujian Provincial Cancer Hospital, Provincial Clinical College of Fujian Medical University, Fujian, China.,Fujian Provincial Key Laboratory of Translational Cancer Medicine, Fujian, China
| | - Wai Tong Ng
- Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Hong Kong, China
| | - Jing Feng Zong
- Department of Radiation Oncology, Fujian Provincial Cancer Hospital, Provincial Clinical College of Fujian Medical University, Fujian, China.,Fujian Provincial Key Laboratory of Translational Cancer Medicine, Fujian, China
| | - Sarah W M Lee
- Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Hong Kong, China
| | - Horace C W Choi
- Department of Systems Engineering and Engineering Management, City University of Hong Kong, Hong Kong, China
| | - Lucy L K Chan
- Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Hong Kong, China
| | - Shao Jun Lin
- Department of Radiation Oncology, Fujian Provincial Cancer Hospital, Provincial Clinical College of Fujian Medical University, Fujian, China.,Fujian Provincial Key Laboratory of Translational Cancer Medicine, Fujian, China
| | - Qiao Juan Guo
- Department of Radiation Oncology, Fujian Provincial Cancer Hospital, Provincial Clinical College of Fujian Medical University, Fujian, China.,Fujian Provincial Key Laboratory of Translational Cancer Medicine, Fujian, China
| | - Henry C K Sze
- Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Hong Kong, China
| | - Yun Bin Chen
- Department of Radiology, Fujian Provincial Cancer Hospital, Provincial Clinical College of Fujian Medical University, Fujian, China
| | - You Ping Xiao
- Department of Radiology, Fujian Provincial Cancer Hospital, Provincial Clinical College of Fujian Medical University, Fujian, China
| | - Wai Kuen Kan
- Department of Diagnostic Radiology, Pamela Youde Nethersole Eastern Hospital, Hong Kong, China
| | - Brian O'Sullivan
- Department of Radiation Oncology, Princess Margaret Cancer Centre/University of Toronto, Toronto, Ontario, Canada
| | - Wei Xu
- Department of Biostatistics, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Quynh Thu Le
- Department of Radiation Oncology, Stanford University, Stanford, California
| | - Christine M Glastonbury
- Department of Clinical Radiology, University of California San Francisco, San Francisco, California
| | - A Dimitrios Colevas
- Department of Medicine (Oncology), Stanford Cancer Institute, Stanford University, Stanford, California
| | - Randal S Weber
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - William Lydiatt
- Department of Otolaryngology, University of Nebraska Medical Center, Omaha, Nebraska
| | - Jatin P Shah
- Department of Head and Neck Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Anne W M Lee
- Department of Clinical Oncology, University of Hong Kong/University of Hong Kong-Shenzhen Hospital, Hong Kong, China.
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15
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Lu T, Guo Q, Cui X, Chen Z, Lin S, Xu L, Lin J, Zong J, Pan J. Prognostic Evaluation of Nasopharyngeal Carcinoma with Bone-Only Metastasis after Therapy. Yonsei Med J 2016; 57:840-5. [PMID: 27189275 PMCID: PMC4951458 DOI: 10.3349/ymj.2016.57.4.840] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Revised: 12/04/2015] [Accepted: 12/09/2015] [Indexed: 11/29/2022] Open
Abstract
PURPOSE To evaluate the prognosis of nasopharyngeal carcinoma (NPC) patients who developed bone-only metastasis after primary treatment and the stratification of these patients into different risk groups based on independent prognostic factors. MATERIALS AND METHODS Eighty NPC patients who developed bone-only metastasis after definitive radiotherapy from October 2005 to December 2010 were enrolled. All these patients received palliative treatment for bone metastasis, including chemotherapy and/or radiotherapy. Clinical features, treatment modality, and laboratory parameters were examined with univariate and multivariate analyses. RESULTS The median follow-up time was 15.5 months (range, 2-67 months) for the whole cohort. The median overall metastatic survival (OMS) time and the 2-year estimate OMS rate were 26.5 months and 52%, respectively. Multivariate analysis indicated that patients with short metastases-free interval, multiple bone metastases sites, high serum lactic dehydrogenase levels, and treated with radiotherapy or chemotherapy alone had significantly worse outcomes. Patients were stratified into three different risk groups based on the number of adverse factors present. The OMS curves of the three groups were all significantly different (p<0.001). CONCLUSION Severl prognostic factors were found to be associated with worse outcomes. According to the number of adverse factors present, bone-only metastasis patients can be stratified into three risk groups with significantly different prognoses. Such grouping may help in improving the design of clinical trials and in guiding individualized treatment for NPC patients with bone-only metastasis.
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Affiliation(s)
- Tianzhu Lu
- Provincial Clinical College, Fujian Medical University, Fuzhou, Fujian, China
- Department of Radiation Oncology, Fujian Provincial Cancer Hospital, Fuzhou, Fujian, China
- Fujian Provincial Key Laboratory of Translational Cancer Medicine, Fuzhou, Fujian, China
| | - Qiaojuan Guo
- Provincial Clinical College, Fujian Medical University, Fuzhou, Fujian, China
- Department of Radiation Oncology, Fujian Provincial Cancer Hospital, Fuzhou, Fujian, China
- Fujian Provincial Key Laboratory of Translational Cancer Medicine, Fuzhou, Fujian, China
| | - Xiaofei Cui
- Provincial Clinical College, Fujian Medical University, Fuzhou, Fujian, China
- Department of Radiation Oncology, Fujian Provincial Cancer Hospital, Fuzhou, Fujian, China
- Fujian Provincial Key Laboratory of Translational Cancer Medicine, Fuzhou, Fujian, China
| | - Zhuhong Chen
- Provincial Clinical College, Fujian Medical University, Fuzhou, Fujian, China
- Department of Radiation Oncology, Fujian Provincial Cancer Hospital, Fuzhou, Fujian, China
- Fujian Provincial Key Laboratory of Translational Cancer Medicine, Fuzhou, Fujian, China
| | - Shaojun Lin
- Provincial Clinical College, Fujian Medical University, Fuzhou, Fujian, China
- Department of Radiation Oncology, Fujian Provincial Cancer Hospital, Fuzhou, Fujian, China
- Fujian Provincial Key Laboratory of Translational Cancer Medicine, Fuzhou, Fujian, China
| | - Luying Xu
- Provincial Clinical College, Fujian Medical University, Fuzhou, Fujian, China
- Department of Radiation Oncology, Fujian Provincial Cancer Hospital, Fuzhou, Fujian, China
- Fujian Provincial Key Laboratory of Translational Cancer Medicine, Fuzhou, Fujian, China
| | - Jin Lin
- Provincial Clinical College, Fujian Medical University, Fuzhou, Fujian, China
- Department of Radiation Oncology, Fujian Provincial Cancer Hospital, Fuzhou, Fujian, China
- Fujian Provincial Key Laboratory of Translational Cancer Medicine, Fuzhou, Fujian, China
| | - Jingfeng Zong
- Provincial Clinical College, Fujian Medical University, Fuzhou, Fujian, China
- Department of Radiation Oncology, Fujian Provincial Cancer Hospital, Fuzhou, Fujian, China
- Fujian Provincial Key Laboratory of Translational Cancer Medicine, Fuzhou, Fujian, China
| | - Jianji Pan
- Provincial Clinical College, Fujian Medical University, Fuzhou, Fujian, China
- Department of Radiation Oncology, Fujian Provincial Cancer Hospital, Fuzhou, Fujian, China
- Fujian Provincial Key Laboratory of Translational Cancer Medicine, Fuzhou, Fujian, China.
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16
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Guo Q, Lu T, Lin S, Zong J, Chen Z, Cui X, Zhang Y, Pan J. Long-term survival of nasopharyngeal carcinoma patients with Stage II in intensity-modulated radiation therapy era. Jpn J Clin Oncol 2016; 46:241-7. [DOI: 10.1093/jjco/hyv192] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Accepted: 11/22/2015] [Indexed: 11/14/2022] Open
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17
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Zeng L, Guo P, Li JG, Han F, Li Q, Lu Y, Deng XW, Zhang QY, Lu TX. Prognostic score models for survival of nasopharyngeal carcinoma patients treated with intensity-modulated radiotherapy and chemotherapy. Oncotarget 2015; 6:39373-83. [PMID: 26415223 PMCID: PMC4770779 DOI: 10.18632/oncotarget.5781] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Accepted: 09/04/2015] [Indexed: 02/05/2023] Open
Abstract
PURPOSE To establish accurate prognostic score models to predict survival for patients with nasopharyngeal carcinoma (NPC), treated with intensity-modulated radiotherapy (IMRT) and chemotherapy. MATERIALS AND METHODS Six hundred and seventy-five patients with newly diagnosed, nonmetastatic and histologically proven NPC who were treated with IMRT and chemotherapy were analyzed retrospectively. Samples were split randomly into a training set (n = 338) and a test set (n = 337) to analyze. All data from the training set were used to perform an extensive survival analysis and to develop multivariate nomograms based on Cox regression. Data from the test set was used as an external validation set. Risk group stratification was proposed for the nomograms. RESULTS The nomograms are able to predict survival with a C-index for external validation of local recurrence-free survival (LRFS; 0.66, 95% CI: 0.58-0.74), distant metastasis-free survival (DMFS; 0.73, 95% CI: 0.66-0.79), and disease-specific survival (DSS; 0.73, 95% CI: 0.67-0.79). The calibration curve for probability of survival showed good agreement between prediction by nomogram and actual observation. The C-index of the nomogram for LRFS, DMFS and DSS were statistically higher than the C-index values of the AJCC seventh edition (P < 0.001). In the test set, the nomogram discrimination was also superior to the AJCC Staging systems (P < 0.001). The stratification in risk groups allows significant distinction between Kaplan-Meier curves for outcome. CONCLUSIONS Prognostic score models were successfully established and validated to predict LRFS, DMFS, and DSS over a 5-year period after IMRT and chemotherapy, which will be useful for individual treatment.
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Affiliation(s)
- Lei Zeng
- State Key Laboratory Oncology in South China, Collaborative Innovation Center of Cancer Medicine, PR China
- Department of Radiation Oncology, Sun Yat-Sen University Cancer Center, PR China
- Department of Radiation Oncology, Jiangxi Cancer Hospital, Nanchang, PR China
| | - Pi Guo
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen University, PR China
| | - Jin-Gao Li
- Department of Radiation Oncology, Jiangxi Cancer Hospital, Nanchang, PR China
| | - Fei Han
- State Key Laboratory Oncology in South China, Collaborative Innovation Center of Cancer Medicine, PR China
- Department of Radiation Oncology, Sun Yat-Sen University Cancer Center, PR China
| | - Qiang Li
- Department of Radiation Oncology, Jiangxi Cancer Hospital, Nanchang, PR China
| | - Yong Lu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen University, PR China
| | - Xiao-Wu Deng
- State Key Laboratory Oncology in South China, Collaborative Innovation Center of Cancer Medicine, PR China
- Department of Radiation Oncology, Sun Yat-Sen University Cancer Center, PR China
| | - Qing-Ying Zhang
- Department of Preventive Medicine, Shantou University Medical College, Shantou, PR China
| | - Tai-Xiang Lu
- State Key Laboratory Oncology in South China, Collaborative Innovation Center of Cancer Medicine, PR China
- Department of Radiation Oncology, Sun Yat-Sen University Cancer Center, PR China
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18
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Wei XL, Zhang DS, He MM, Jin Y, Wang DS, Zhou YX, Bai L, Li ZZ, Luo HY, Wang FH, Xu RH. The predictive value of alkaline phosphatase and lactate dehydrogenase for overall survival in patients with esophageal squamous cell carcinoma. Tumour Biol 2015; 37:1879-87. [PMID: 26323257 DOI: 10.1007/s13277-015-3851-y] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Accepted: 07/27/2015] [Indexed: 12/30/2022] Open
Abstract
The elevation of alkaline phosphatase (ALP) and lactate dehydrogenase (LDH) has been demonstrated to predict worse prognosis in various malignancies; however, their prognostic value in esophageal squamous cell carcinoma has not been well studied. We conducted a retrospective study of 906 patients with esophageal squamous cell carcinoma to explore their prognostic value for overall survival. The optimal cutoff points for ALP and LDH were determined. We analyzed the association between the levels of ALP and LDH and clinicopathological characteristics. Their prognostic value for overall survival was explored by univariate and multivariate analysis. We also proposed the ALP and LDH classification and examined its prognostic value in the general population and subgroups. The optimal cutoff points of ALP and LDH to predict overall survival were 90.7 and 361.5 U/L respectively. Higher levels of ALP and LDH were both associated with more advanced TNM stage (P = 0.003 and 0.002, respectively) and more distant metastasis (P = 0.001 and P < 0.001, respectively). Both ALP (≤90.7/>90.7 U/L) and LDH (≤361.5/>361.5 U/L) were independent prognostic factors for overall survival in esophageal squamous cell carcinoma (P = 0.004 and P < 0.001 by multivariate analysis). The ALP and LDH classification categorized patients into three subgroups with distinct prognosis (P < 0.001 by multivariate analysis) and identified a small group of patients who had extremely poor overall survival with a median of 4.2 months. In conclusion, ALP and LDH were both independent prognostic factors for overall survival. A combination of the two indexes might contribute to further identification of survival differences in esophageal squamous cell carcinoma.
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Affiliation(s)
- Xiao-Li Wei
- Department of Medical Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, 651 Dong Feng Road East, Guangzhou, 510060, Guangdong Province, China
| | - Dong-Sheng Zhang
- Department of Medical Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, 651 Dong Feng Road East, Guangzhou, 510060, Guangdong Province, China
| | - Ming-Ming He
- Department of Medical Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, 651 Dong Feng Road East, Guangzhou, 510060, Guangdong Province, China
| | - Ying Jin
- Department of Medical Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, 651 Dong Feng Road East, Guangzhou, 510060, Guangdong Province, China
| | - De-Shen Wang
- Department of Medical Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, 651 Dong Feng Road East, Guangzhou, 510060, Guangdong Province, China
| | - Yi-Xin Zhou
- Department of Medical Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, 651 Dong Feng Road East, Guangzhou, 510060, Guangdong Province, China
| | - Long Bai
- Department of Medical Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, 651 Dong Feng Road East, Guangzhou, 510060, Guangdong Province, China
| | - Zhe-Zhen Li
- Department of Medical Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, 651 Dong Feng Road East, Guangzhou, 510060, Guangdong Province, China
| | - Hui-Yan Luo
- Department of Medical Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, 651 Dong Feng Road East, Guangzhou, 510060, Guangdong Province, China
| | - Feng-Hua Wang
- Department of Medical Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, 651 Dong Feng Road East, Guangzhou, 510060, Guangdong Province, China
| | - Rui-Hua Xu
- Department of Medical Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, 651 Dong Feng Road East, Guangzhou, 510060, Guangdong Province, China.
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19
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Jung SH, Yang DH, Ahn JS, Kim YK, Kim HJ, Lee JJ. Serum lactate dehydrogenase with a systemic inflammation score is useful for predicting response and survival in patients with newly diagnosed diffuse large B-cell lymphoma. Acta Haematol 2014; 133:10-7. [PMID: 24969101 DOI: 10.1159/000360068] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Accepted: 01/27/2014] [Indexed: 01/21/2023]
Abstract
We evaluated the relationship between serum lactate dehydrogenase (LDH) level with systemic inflammation score and survival in 213 patients with diffuse large B-cell lymphoma (DLBCL) receiving R-CHOP chemotherapy. The patients were classified into 3 groups based on LDH with the Glasgow Prognostic Score (L-GPS). A score of 2 was assigned to patients with elevated C-reactive protein, hypoalbuminemia and elevated LDH, a score of 1 to those with one or two abnormalities and a score of 0 to those with no abnormality. In multivariate analysis, independent poor prognostic factors for progression-free survival were L-GPS 2 [hazard ratio (HR) 5.415, p = 0.001], Eastern Cooperative Oncology Group performance status (ECOG PS) ≥2 (HR 3.504, p = 0.001) and bulky lesion (HR 2.030, p = 0.039). Independent poor prognostic factors for overall survival were L-GPS 2 (HR 5.898, p = 0.001) and ECOG PS ≥2 (HR 3.525, p = 0.001). The overall response rate for the R-CHOP chemotherapy decreased according to the L-GPS; it was 96.7% at L-GPS 0, 87% at L-GPS 1 and 75% at L-GPS 2 (p = 0.009). L-GPS based on systemic inflammatory indicators may be a useful clinical prognostic indicator for survival, and predicts the response for R-CHOP chemotherapy in patients with newly diagnosed DLBCL.
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MESH Headings
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Antibodies, Monoclonal, Murine-Derived/therapeutic use
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- C-Reactive Protein/metabolism
- Cyclophosphamide/therapeutic use
- Doxorubicin/therapeutic use
- Female
- Humans
- Inflammation Mediators/blood
- Lactate Dehydrogenases/blood
- Lymphoma, Large B-Cell, Diffuse/blood
- Lymphoma, Large B-Cell, Diffuse/diagnosis
- Lymphoma, Large B-Cell, Diffuse/drug therapy
- Lymphoma, Large B-Cell, Diffuse/mortality
- Male
- Middle Aged
- Neoplasm Metastasis
- Neoplasm Staging
- Prednisone/therapeutic use
- Prognosis
- Retrospective Studies
- Rituximab
- Treatment Outcome
- Vincristine/therapeutic use
- Young Adult
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Affiliation(s)
- Sung-Hoon Jung
- Department of Hematology-Oncology, Chonnam National University Hwasun Hospital, Hwasun, Republic of Korea
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Wei Z, Zeng X, Xu J, Duan X, Xie Y. Prognostic value of pretreatment serum levels of lactate dehydrogenase in nonmetastatic nasopharyngeal carcinoma: single-site analysis of 601 patients in a highly endemic area. Onco Targets Ther 2014; 7:739-49. [PMID: 24868167 PMCID: PMC4031205 DOI: 10.2147/ott.s59804] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Background Numerous studies have generated promising but incomplete evidence for the prognostic value of pretreatment serum levels of lactate dehydrogenase (S-LDH) in nasopharyngeal carcinoma (NPC). Methods Pretreatment serum levels of S-LDH in 601 patients with NPC were measured before treatment, and their associations with overall survival and tumor-free survival were studied. Univariate and multivariate analysis of subgroups was used to evaluate the prognostic value of S-LDH in early-stage and late-stage NPC separately. Results Pretreatment S-LDH levels were significantly lower in T1+2 patients than in T3+4 patients, lower in N0+1 patients than in N2+3 ones, and lower in stage I + II patients than in III + IV ones. Multivariate analysis showed that among patients with late-stage NPC, high pretreatment S-LDH levels >225 U/L were an independent predictor of poor overall survival and tumor-free survival. Among patients with early-stage NPC, pretreatment S-LDH levels >171 U/L, which overlap with the normal range, were an independent predictor of shorter overall survival and tumor-free survival. Conclusion Pretreatment S-LDH levels may be a reliable biomarker for predicting the long-term prognosis of patients with early-stage or late-stage NPC.
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Affiliation(s)
- Zhengbo Wei
- Department of Head and Neck Tumor Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, People's Republic of China
| | - Xianjie Zeng
- Department of Head and Neck Tumor Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, People's Republic of China
| | - Jian Xu
- Department of Head and Neck Tumor Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, People's Republic of China
| | - Xuwei Duan
- Department of Head and Neck Tumor Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, People's Republic of China
| | - Ying Xie
- Guangxi Key Laboratory for High-Incidence Tumor Prevention and Treatment, Experimental Center of Medical Science of Guangxi Medical University, Nanning, People's Republic of China
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Tao CJ, Liu X, Tang LL, Mao YP, Chen L, Li WF, Yu XL, Liu LZ, Zhang R, Lin AH, Ma J, Sun Y. Prognostic scoring system for locoregional control among the patients with nasopharyngeal carcinoma treated by intensity-modulated radiotherapy. CHINESE JOURNAL OF CANCER 2013; 32:494-501. [PMID: 23981849 PMCID: PMC3845563 DOI: 10.5732/cjc.013.10121] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The prognostic value of T category for locoregional control in patients with nasopharyngeal carcinoma (NPC) has decreased with the extensive use of intensity-modulated radiotherapy (IMRT). We aimed to develop a prognostic scoring system (PSS) that incorporated tumor extension and clinical characteristics for locoregional control in NPC patients treated with IMRT. The magnetic resonance imaging scans and medical records of 717 patients with nonmetastatic NPC treated with IMRT at Sun Yat-sen University Cancer Center between January 2003 and January 2008 were reviewed. Age, pathologic classification, primary tumor extension, primary gross tumor volume (GTV-p), T and N categories, and baseline lactate dehydrogenase (LDH) level were analyzed. Hierarchical cluster analysis as well as univariate and multivariate analyses were used to develop the PSS. Independent prognostic factors for locoregional relapse included N2–3 stage, GTV-p ≥26.8 mL, and involvement of one or more structures within cluster 3. We calculated a risk score derived from the regression coefficient of each factor and classified patients into four groups: low risk (score 0), intermediate risk (score >0 and ≤1), high risk (score >1 and ≤2), and extremely high risk (score >2). The 5-year locoregional control rates for these groups were 97.4%, 93.6%, 85.2%, and 78.6%, respectively (P < 0.001). We have developed a PSS that can help identify NPC patients who are at high risk for locoregional relapse and can guide individualized treatments for NPC patients.
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Affiliation(s)
- Chang-Juan Tao
- State Key Laboratory of Oncology in South China; Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong 510060, P. R. China. ,sunying@ sysucc.org.cn
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Jin Y, Ye X, Shao L, Lin BC, He CX, Zhang BB, Zhang YP. Serum lactic dehydrogenase strongly predicts survival in metastatic nasopharyngeal carcinoma treated with palliative chemotherapy. Eur J Cancer 2013; 49:1619-26. [PMID: 23266049 DOI: 10.1016/j.ejca.2012.11.032] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2012] [Revised: 11/19/2012] [Accepted: 11/21/2012] [Indexed: 11/24/2022]
Abstract
BACKGROUND AND OBJECTIVE The survival outcomes of patients with metastatic nasopharyngeal carcinoma (NPC) differ significantly between individuals. This study aimed to evaluate whether serum lactic dehydrogenase (S-LDH) level had a clinical value in predicting clinical response and survival outcome for patients with metastatic NPC. METHODS S-LDH level was measured at baseline and then before every cycle of treatment in 689 NPC patients with distant metastases. Correlations of pre-treatment and post-treatment S-LDH levels to response of treatment and survival were analysed retrospectively. RESULTS Patients with elevated values of pre-treatment S-LDH (>245 IU/L) had significantly worse survival than those with normal values of pre-treatment S-LDH (≤245 IU/L) (P<0.001). Patients with elevated values of post-treatment S-LDH had worse survival compared with those with normal values of post-treatment S-LDH (P<0.001). Patients with normal values of pre-treatment and post-treatment S-LDH showed the highest response rate and the most favourable prognosis. CONCLUSION S-LDH appears to be a significant independent prognostic index in patients with disseminated NPC that should be considered in the comparison of the results achieved with different therapies and in planning new randomised clinical therapeutic trials.
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Affiliation(s)
- Y Jin
- Department of Medical Oncology, Zhejiang Cancer Hospital, Hangzhou, China
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High pretreatment serum lactate dehydrogenase level correlates with disease relapse and predicts an inferior outcome in locally advanced nasopharyngeal carcinoma. Eur J Cancer 2013; 49:2356-64. [PMID: 23541571 DOI: 10.1016/j.ejca.2013.03.008] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2012] [Revised: 02/05/2013] [Accepted: 03/04/2013] [Indexed: 01/29/2023]
Abstract
PURPOSE Here, we evaluate the prognostic effect of pretreatment serum lactate dehydrogenase (LDH) in locally advanced nasopharyngeal carcinoma (NPC). METHODS AND MATERIALS Pretreatment serum samples from a randomized controlled trial, which contained 199 neoadjuvant chemoradiotherapy patients and 201 neoadjuvant-concurrent chemoradiotherapy cases with locally advanced NPC, were collected and examined for LDH. With 5-year follow-up, the prognostic effect of pretreatment serum LDH was analysed by Kaplan-Meier analysis and multivariate Cox regression model. RESULTS Three hundred and sixty-seven patients (91.75%) had a normal (109.0-245.0 U/L) pretreatment LDH level, compared to 33 cases (8.25%) that had a higher (≥245.0 U/L) LDH level. The mean and median pretreatment LDH levels of these 400 patients were 186.6 and 174.0 U/L (range, 83.0-751.0 U/L), respectively. Compared with the normal subset, elevated LDH level predicted an inferior 5-year overall survival (56.9% versus 76.8%, P=0.004), disease-free survival (DFS, 45.4% versus 64.7%, P=0.001), local relapse-free survival (76.1% versus 89.6%, P=0.019) and distant metastasis-free survival (DMFS, 54.3% versus 72.2%, P=0.001). Multivariate analysis confirmed that the LDH level was an independent prognostic factor to predict death, disease progression, local relapse and distant metastasis. For the subgroup with normal LDH (median point of 177.0 U/L), we detected an evident 5-year DFS (68.8% versus 59.5%, P=0.047) and DMFS advantage (77.3% versus 65.3%, P=0.016) in 109.0-177.0 U/L subset than that of 178.0-245.0 U/L subgroup. CONCLUSIONS Serological LDH level was an independent prognostic factor for locally advanced NPC. Combining pretreatment LDH with TNM staging might lead to more accurate risk definition.
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Liu N, Cui RX, He QM, Huang BJ, Sun Y, Xie D, Zeng J, Wang HY, Ma J. Reduced expression of Dicer11 is associated with poor prognosis in patients with nasopharyngeal carcinoma. Med Oncol 2013; 30:360. [PMID: 23307239 DOI: 10.1007/s12032-012-0360-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2012] [Accepted: 09/02/2012] [Indexed: 11/28/2022]
Abstract
Dicer11 plays an important role in generation of microRNA and is dysregulated in a variety of human cancers. The purpose of this study was to evaluate Dicer11 expression and its prognostic value in nasopharyngeal carcinoma (NPC). The protein expression of Dicer1 was examined by immunohistochemistry in 276 NPC specimens, and the mRNA levels of Dicer1 were analyzed by qRT-PCR in 56 NPC and 11 nasopharyngitis tissues. Cox regression analysis was used to identify independent prognostic factors, and a prognostic score model was constructed for survival prediction. Expression of Dicer1 was downregulated in NPC tissues at both the mRNA and the protein levels, and there was a notable positive correlation between the expression levels of Dicer1 mRNA and protein. Low Dicer1 expression was positively correlated with distant metastasis (P < 0.01) and death (P = 0.01). In addition, low expression of Dicer1 was significantly associated with poorer overall survival (HR, 2.32; 95 % CI 1.30-4.14; P < 0.01) and poorer distant metastasis-free survival (HR, 2.56; 95 % CI 1.39-4.74; P < 0.01). Furthermore, multivariate analysis showed that low expression of Dicer1 and tumor-node-metastasis (TNM) stage was independent prognostic indicators for NPC patients. A prognostic score model combining the Dicer1 expression and TNM stage had a better prognostic value than the TNM stage alone model or Dicer1 expression alone model (P < 0.05). Dicer1 was downregulated in NPC tissues at both the mRNA and the protein levels, and low expression of Dicer1 could be served as novel prognostic biomarker for NPC patients.
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Affiliation(s)
- Na Liu
- State Key Laboratory of Oncology in South China, Department of Radiation Oncology, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou 510060, People's Republic of China
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Liu N, Chen NY, Cui RX, Li WF, Li Y, Wei RR, Zhang MY, Sun Y, Huang BJ, Chen M, He QM, Jiang N, Chen L, Cho WCS, Yun JP, Zeng J, Liu LZ, Li L, Guo Y, Wang HY, Ma J. Prognostic value of a microRNA signature in nasopharyngeal carcinoma: a microRNA expression analysis. Lancet Oncol 2012; 13:633-41. [PMID: 22560814 DOI: 10.1016/s1470-2045(12)70102-x] [Citation(s) in RCA: 243] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND MicroRNAs (miRNAs) can be used as prognostic biomarkers in many types of cancer. We aimed to identify miRNAs that were prognostic in patients with nasopharyngeal carcinoma. METHODS We retrospectively analysed miRNA expression profiles in 312 paraffin-embedded specimens of nasopharyngeal carcinoma from Sun Yat-sen University Cancer Center (Guangzhou, China) and 18 specimens of non-cancer nasopharyngitis. Using an 873 probe microarray, we assessed associations between miRNA signatures and clinical outcome in a randomly selected 156 samples (training set) and validated findings in the remaining 156 samples (internal validation set). We confirmed the miRNAs signature using quantitative RT-PCR analysis in 156 samples from a second randomisation of the 312 samples, and validated the miRNA signature in 153 samples from the West China Hospital of Sichuan University in Chengdu, China (independent set). We used the Kaplan-Meier method and log-rank tests to estimate correlations of the miRNA signature with disease-free survival (DFS), distant metastasis-free survival (DMFS), and overall survival. FINDINGS 41 miRNAs were differentially expressed between nasopharyngeal carcinoma and non-cancer nasopharyngitis tissues. A signature of five miRNAs, each significantly associated with DFS, was identified in the training set. We calculated a risk score from the signature and classified patients as high risk or low risk. Compared with patients with low-risk scores, patients with high risk scores in the training set had shorter DFS (hazard ratio [HR] 2·73, 95% CI 1·46-5·11; p=0·0019), DMFS (3·48, 1·57-7·75; p=0·0020), and overall survival (2·48, 1·24-4·96; p=0·010). We noted equivalent findings in the internal validation set for DFS (2·47, 1·32-4·61; p=0·0052), DMFS (2·28, 1·09-4·80; p=0·030), and overall survival (2·87, 1·38-5·96; p=0·0051) and in the independent set for DFS (3·16, 1·65-6·04; p=0·0011), DMFS (2·39, 1·05-5·42; p=0·037), and overall survival (3·07, 1·34-7·01; p=0·0082). The five-miRNA signature was an independent prognostic factor. A combination of this signature and TNM stage had better prognostic value than did TNM stage alone in the training set (area under receiver operating characteristics 0·68 [95% CI 0·60-0·76] vs 0·60 [0·52-0·67]; p=0·013), the internal validation set (0·70 [0·61-0·78] vs 0·61 [0·54-0·68]; p=0·012), and the independent set (0·70 [0·62-0·78] vs 0·63 [0·56-0·69]; p=0·032). INTERPRETATION Identification of patients with the five-miRNA signature might add prognostic value to the TNM staging system and inform treatment decisions for patients at high risk of progression. FUNDING Science Foundation of Chinese Ministry of Health, National Natural Science Foundation of China, Pearl River Scholar Funded Scheme, Guangdong Key Scientific and Technological Innovation Program, Guangdong Natural Science Foundation, Fundamental Research Funds for the Central Universities.
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Affiliation(s)
- Na Liu
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China
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To build a prognostic score model containing indispensible tumour markers for metastatic nasopharyngeal carcinoma in an epidemic area. Eur J Cancer 2011; 48:882-8. [PMID: 22030451 DOI: 10.1016/j.ejca.2011.09.004] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2011] [Revised: 08/21/2011] [Accepted: 09/23/2011] [Indexed: 11/22/2022]
Abstract
BACKGROUND AND OBJECTIVE The survival outcomes of patients with metastatic nasopharyngeal carcinoma (NPC) differ significantly between individuals. The aim of this study is to build a prognostic score model (PSM) incorporating circulating tumour markers for metastatic NPC in an epidemic area. METHODS Seven hundred and ninety-nine patients with disseminated NPC were analysed retrospectively. Univariate and multivariable analyses were conducted using the Cox proportion hazards model. Factors analysed included patients' characteristics (gender, age group, performance status), circulating tumour-marker characteristics (Epstein-Barr virus (EBV) DNA level, EBV VCA-IgA level, lactate dehydrogenase (LDH) level, alkaline phosphatase (ALP) level), basic laboratory characteristics (leucocyte count, haemoglobin level, albumin level), and disease characteristics (presence of metastasis at presentation, disease-free interval, number of metastatic sites, specific metastatic sites). The PSM was built according to numerical score derived from the regression coefficients of each independent prognostic variable. The prognostic score of each patient was calculated by totalling up the scores of each independent variable. RESULTS Independent prognostic factors included performance status, age, haemoglobin level, LDH level, ALP level and EBV DNA level. Three prognostic groups based on PSM were obtained: low risk (total score=0-4); intermediate risk (5-8); high risk (9-12). Median survivals of the three groups were 25.5, 15.1 and 7 months, respectively, (P<0.001). CONCLUSION Clinical and laboratory characteristics can help guide the prognostication of patients with metastatic NPC in epidemic areas.
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Zhou GQ, Tang LL, Mao YP, Chen L, Li WF, Sun Y, Liu LZ, Li L, Lin AH, Ma J. Baseline serum lactate dehydrogenase levels for patients treated with intensity-modulated radiotherapy for nasopharyngeal carcinoma: a predictor of poor prognosis and subsequent liver metastasis. Int J Radiat Oncol Biol Phys 2011; 82:e359-65. [PMID: 22000748 DOI: 10.1016/j.ijrobp.2011.06.1967] [Citation(s) in RCA: 96] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2011] [Revised: 06/03/2011] [Accepted: 06/14/2011] [Indexed: 11/15/2022]
Abstract
PURPOSE To evaluate the prognostic value of baseline serum lactate dehydrogenase (LDH) levels in patients with nasopharyngeal carcinoma (NPC) treated with intensity-modulated radiotherapy (IMRT). METHODS AND MATERIALS Cases of NPC (n = 465) that involved treatment with IMRT with or without chemotherapy were retrospectively analyzed. RESULTS The mean (±SD) and median baseline serum LDH levels for this cohort were 172.77 ± 2.28 and 164.00 IU/L, respectively. Levels of LDH were significantly elevated in patients with locoregionally advanced disease (p = 0.016). Elevated LDH levels were identified as a prognostic factor for rates of overall survival (OS), disease-free survival (DFS), and distant metastasis-free survival (DMFS), with p values <0.001 in the univariate analysis and p < 0.001, p = 0.004, and p = 0.003, respectively, in the multivariate analysis. Correspondingly, the prognostic impact of patient LDH levels was found to be statistically significant for rates of OS, DFS, and DMFS (p = 0.028, 0.024, and 0.020, respectively). For patients who experienced subsequent liver failure after treatment, markedly higher pretreatment serum LDH levels were detected compared with patients experiencing distant metastasis events at other sites (p = 0.032). CONCLUSIONS Elevated baseline LDH levels are associated with clinically advanced disease and are a poor prognosticator for OS, DFS, and DMFS for NPC patients. These results suggest that elevated serum levels of LDH should be considered when evaluating treatment options.
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Affiliation(s)
- Guan-Qun Zhou
- Department of Radiation Oncology, Cancer Center, State Key Laboratory of Oncology in South China, Sun Yat-sen University, Guangzhou, People's Republic of China
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Chang YH, Wu CC, Chang KP, Yu JS, Chang YC, Liao PC. Cell Secretome Analysis Using Hollow Fiber Culture System Leads to the Discovery of CLIC1 Protein as a Novel Plasma Marker for Nasopharyngeal Carcinoma. J Proteome Res 2009; 8:5465-74. [DOI: 10.1021/pr900454e] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Ying-Hwa Chang
- Institute of Biopharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan, Molecular Medicine Research Center, Chang Gung University, Tao-Yuan, Taiwan, Department of Otolaryngology-Head Neck Surgery, Chang Gung Memorial Hospital, Lin-Kou, Taiwan, Department of Biochemistry and Molecular Biology, Chang Gung University, Tao-Yuan, Taiwan, Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan, and
| | - Chih-Ching Wu
- Institute of Biopharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan, Molecular Medicine Research Center, Chang Gung University, Tao-Yuan, Taiwan, Department of Otolaryngology-Head Neck Surgery, Chang Gung Memorial Hospital, Lin-Kou, Taiwan, Department of Biochemistry and Molecular Biology, Chang Gung University, Tao-Yuan, Taiwan, Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan, and
| | - Kai-Ping Chang
- Institute of Biopharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan, Molecular Medicine Research Center, Chang Gung University, Tao-Yuan, Taiwan, Department of Otolaryngology-Head Neck Surgery, Chang Gung Memorial Hospital, Lin-Kou, Taiwan, Department of Biochemistry and Molecular Biology, Chang Gung University, Tao-Yuan, Taiwan, Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan, and
| | - Jau-Song Yu
- Institute of Biopharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan, Molecular Medicine Research Center, Chang Gung University, Tao-Yuan, Taiwan, Department of Otolaryngology-Head Neck Surgery, Chang Gung Memorial Hospital, Lin-Kou, Taiwan, Department of Biochemistry and Molecular Biology, Chang Gung University, Tao-Yuan, Taiwan, Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan, and
| | - Yu-Chen Chang
- Institute of Biopharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan, Molecular Medicine Research Center, Chang Gung University, Tao-Yuan, Taiwan, Department of Otolaryngology-Head Neck Surgery, Chang Gung Memorial Hospital, Lin-Kou, Taiwan, Department of Biochemistry and Molecular Biology, Chang Gung University, Tao-Yuan, Taiwan, Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan, and
| | - Pao-Chi Liao
- Institute of Biopharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan, Molecular Medicine Research Center, Chang Gung University, Tao-Yuan, Taiwan, Department of Otolaryngology-Head Neck Surgery, Chang Gung Memorial Hospital, Lin-Kou, Taiwan, Department of Biochemistry and Molecular Biology, Chang Gung University, Tao-Yuan, Taiwan, Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan, and
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Shin YK, Yoo BC, Hong YS, Chang HJ, Jung KH, Jeong SY, Park JG. Upregulation of glycolytic enzymes in proteins secreted from human colon cancer cells with 5-fluorouracil resistance. Electrophoresis 2009; 30:2182-92. [PMID: 19582719 DOI: 10.1002/elps.200800806] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
5-Fluorouracil (5-FU) is the most commonly used chemotherapeutic agent for colorectal cancer (CRC). However, resistance to this drug is a major obstacle in CRC chemotherapy. Accurate prediction of response to 5-FU would avoid unnecessary chemotherapy and allow the selection of other effective drugs. To identify a candidate predictor of 5-FU resistance, we isolated secreted proteins that were up- or downregulated in a 5-FU-resistant cancer cell line, compared with the parent cell line (SNU-C4), using a stable isotope-coded labeling protocol. For validating the clinical applicability of this method, levels of the identified proteins were determined in the sera of 46 patients treated with 5-FU. In total, 238 proteins with molecular weights ranging from 50 to 75 kDa were identified. Among these, 45 and 35 secreted proteins were up- and downregulated in the 5-FU-resistant cell line, respectively. We observed significant upregulation of glycolytic enzymes, including glyceraldehyde-3-phosphate dehydrogenase, pyruvate kinase M2 (PK-M2), transketolase, and NADP(+)-dependent malic enzyme 1. In particular, the level of PK-M2, a key enzyme in the glycolytic pathway, showed an increasing tendency in both sera and tissues from CRC patients displaying no response to 5-FU-based chemotherapy (progressive and stable disease cases), compared with that in complete or partial responders to 5-FU-based chemotherapy; however, it did not reach the statistical significance. In conclusion, increasing pattern of PK-M2 observed with 5-FU resistance induced in vitro and in sera and tissues from CRC patients displaying poor response to 5-FU-based chemotherapy suggest the relevance of dysregulated glycolysis and 5-FU-resistant CRC.
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Cancer’s craving for sugar: an opportunity for clinical exploitation. J Cancer Res Clin Oncol 2009; 135:867-77. [DOI: 10.1007/s00432-009-0590-8] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2009] [Accepted: 04/09/2009] [Indexed: 12/22/2022]
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Zheng Y, Zhao X, Zhou J, Piao Y, Jin S, He Q, Hong J, Li N, Wu C. Identification of yak lactate dehydrogenase B gene variants by gene cloning. ACTA ACUST UNITED AC 2008; 51:430-4. [PMID: 18785588 DOI: 10.1007/s11427-008-0036-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Native polyacrylamide gel electrophoresis showed that two types of lactate dehydrogenase (LDH) existed in yaks. Based on the electrophoresis characteristics of LDH isoenzymes, yak LDH variants were speculated to be the gene mutation on H subunit encoded by B gene. According to the mobility in electrophoresis, the fast-band LDH type was named LDH-Hf and the slow-band LDH type LDH-Hs. In order to reveal the gene alteration in yak LDH variants, total RNA was extracted from heart tissues of yaks with different LDH variants, and cDNAs of the two variants were reverse transcripted. Two variants of B genes were cloned by RT-PCR. Sequence analysis revealed that four nucleotides differed between LDH-Bf and LDH-Bs, which resulted in two amino acids alteration. By Deepview software analysis of the conformation of yak LDH1 variants and H subunit, these four nucleotides altered two amino acids that generated new hydrogen bonds to change the hydrogen bonds network, and further caused subtle conformational changes between the two LDH variants.
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Affiliation(s)
- YuCai Zheng
- College of Life Science and Technology, Southwest University for Nationalities, Chengdu 610041, China
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