HARP（血红蛋白-白蛋白-C反应蛋白）指数：一种用于局部晚期鼻咽癌连续预后建模的生物学设计复合生物标志物
The HARP (Hemoglobin-Albumin-C-Reactive Protein) Index: A Biologically Designed Composite Biomarker for Continuous Prognostic Modeling in Locally Advanced Nasopharyngeal Carcinoma.
文献信息
| PMID | 42783199 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Erkan Topkan |
| 作者单位 | Department of Radiation Oncology, Faculty of Medicine, Başkent University, Adana 01250, Türkiye. |
| 期刊 | Diseases (Basel, Switzerland) |
| SCI 分区 | Q2 |
| IF | 3.7 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 鼻咽癌 |
中文摘要
背景/目的： 评估新型血红蛋白-白蛋白-C反应蛋白（HARP）指数在接受根治性同步放化疗（CCRT）的局部晚期鼻咽癌（LANPC）患者中的预后意义。
方法： 这项回顾性研究纳入2011年至2020年间接受根治性CCRT治疗的248例LANPC患者。HARP指数[血红蛋白×（白蛋白÷C反应蛋白）]使用治疗前实验室值计算。通过连续和分类Cox回归分析、限制性立方样条建模、受试者工作特征分析以及基于bootstrap的内部验证，评估HARP与生存结局之间的预后关联。
结果： 较低的治疗前HARP值与较差的无进展生存期（PFS）和总生存期（OS）独立相关。在连续Cox分析中，HARP值升高与死亡和疾病进展风险降低相关（均p < 0.001）。ROC分析确定3.2作为临床分层的探索性截断值。HARP ≥ 3.2的患者（n = 112）结局显著优于HARP < 3.2的患者（n = 136）。高HARP组的中位PFS和OS未达到，而低HARP组分别为47.0个月和72.0个月。低HARP值与较差的PFS（HR，3.86；p < 0.001）和OS（HR，3.06；p < 0.001）相关。Bootstrap内部验证显示模型区分度稳定，乐观度极小。
结论： 新型HARP指数是接受根治性CCRT治疗的LANPC患者中独立相关且经内部验证的预后生物标志物。HARP可能为改善风险分层提供实用工具，尚待前瞻性外部验证。
英文摘要
BACKGROUND/OBJECTIVES: To evaluate the prognostic significance of the novel hemoglobin-albumin-C-reactive protein (HARP) index in patients with locally advanced nasopharyngeal carcinoma (LANPC) treated with definitive concurrent chemoradiotherapy (CCRT).
METHODS: This retrospective study included 248 patients with LANPC treated with definitive CCRT between 2011 and 2020. The HARP index [hemoglobin × (albumin ÷ C-reactive protein)] was calculated using pretreatment laboratory values. Prognostic associations between HARP and survival outcomes were evaluated using continuous and categorical Cox regression analyses, restricted cubic spline modeling, receiver operating characteristic analyses, and bootstrap-based internal validation.
RESULTS: Lower pretreatment HARP values were independently associated with inferior progression-free survival (PFS) and overall survival (OS). In continuous Cox analyses, increasing HARP values were associated with reduced risks of mortality and disease progression (both p < 0.001). ROC analysis identified 3.2 as the exploratory cut-off value for clinical stratification. Patients with HARP ≥ 3.2 (n = 112) had significantly better outcomes than those with HARP < 3.2 (n = 136). Median PFS and OS were not reached in the high-HARP group, whereas they were 47.0 and 72.0 months, respectively, in the low-HARP group. Low HARP values were associated with inferior PFS (HR, 3.86; p < 0.001) and OS (HR, 3.06; p < 0.001). Bootstrap internal validation demonstrated stable model discrimination with minimal optimism.
CONCLUSIONS: The novel HARP index is an independently associated and internally validated prognostic biomarker in patients with LANPC treated with definitive CCRT. HARP may provide a practical tool for improved risk stratification, pending prospective external validation.