Serum Colorectal Neoplasia Differentially Expressed Level and Prognostic Factors in Patients with RLNM of NPC

Nasopharyngeal carcinoma (NPC) is a malignant tumor with a high incidence. Regional lymph node metastasis (RLNM) affects the benefits to and prognosis of patients after treatment. Researchers speculate that CRNDE expression might have a correlation with NPC lymph node metastasis (LNM), but studies on the subject are relatively few.

The study intended to explore the predictive value of the level of serum colorectal neoplasia differentially expressed (CRNDE) for RLNM in NPC patients and to analyze the effects of RLNM on their long-term prognosis after radiotherapy and chemotherapy, to provide a reference for early prediction, diagnosis, and treatment of RLNM in NPC.

The research team performed a retrospective case-control study.

The study took place at Taizhou People's Hospital in Taizhou, China.

Participants were 80 NPC patients who received treatment using radiotherapy and chemotherapy at the hospital between January 2014 and December 2017.

The research team divided participants into two groups: (1) an observation group diagnosed with RLNM, with 52 participants, and a control group that had no RLNM, with 28 participants.

The research team: (1) determined the level of colorectal neoplasia differentially expressed (CRNDE) in participants' serum to predict the risk of RLNM, (2) compared clinical total response rates (TRRs) between the groups, and (3) analyzed the five-year overall survival (OS), local relapse-free survival (LRFS), and distant metastasis-free survival (DMFS).

Compared with control group, the observation group's CRNDE level was significantly higher, and its five-year OS and DMFS rates were significantly lower (all P < .01). No significant differences existed in the TRR and five-year LRFS rate between the observation and control groups (P > .05). The cut-off value for serum CRNDE was set at 3.540, the area under curve (AUC) value for the observation group was 0.805, and the 95% confidence interval (CI) was 0.715-0.889. In addition, the sensitivity was 88.5%, specificity was 57.1%, and Yoden index was 0.463. The five-year OS rates were significant lower in the observation group patients with metastatic lymph nodes > 2 in number (P = .025) and > 6 cm in diameter (P = .002) and with posterior pharyngeal LNM (P = .049).

An abnormal increase in serum CRNDE can be a basis to diagnose RLNM in NPC patients. RLNM affected the long-term prognosis of NPC patients, and the number and diameter of lymph nodes and posterior pharyngeal metastasis were the factors affecting patients' long-term. The current study's findings can provide a reference for the realization of the early diagnosis of NPC RLNM, formulating the treatment schemes and improving the long-term survival outcome of NPC patients.