鼻咽癌与良性腺样体相关病变中常规炎症生物标志物的探索性比较
Exploratory Comparison of Routine Inflammatory Biomarkers in Nasopharyngeal Carcinoma and Benign Adenoid-Associated Pathology.
文献信息
| PMID | 42929992 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Darius Radu Roman |
| 作者单位 | Doctoral School of Biomedical Sciences, Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania. |
| 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： 鼻咽癌（NPC）可能伴随全身性炎症改变，但常规炎症标志物缺乏特异性，尚未被验证为NPC的诊断性检测。
方法： 本探索性回顾性比较筛选了178名成人，纳入72份合格记录（36例经组织病理学确诊的NPC和36例经组织学确诊的良性腺样体相关病变）；106份记录因内镜或实验室记录不完整（n = 41）、血液系统恶性肿瘤（n = 15）、严重肝功能衰竭（n = 11）或记录有与鼻咽表现无关的全身性炎症性疾病（n = 39）而被排除。比较了CRP、红细胞沉降率（ESR）、白细胞计数、选定的生化变量以及研究者衍生的局部区域临床/内镜严重程度评分。预设的敏感性分析包括年龄和性别校正的秩回归、限制于重叠年龄范围（39-52岁）、分组分层相关性，以及校正诊断分组、年龄和性别的偏秩相关。
结果： NPC组较良性组年轻（38.1 ± 7.6 vs. 56.1 ± 8.3岁；p < 0.001）。NPC组的CRP、ESR、白细胞计数、尿酸和局部区域评分较高（均p < 0.01）。主要差异在重叠年龄亚组（NPC n = 17；良性 n = 16；均p < 0.001）以及年龄和性别校正的秩分析中持续存在。合并相关性在分层和协变量校正后减弱或改变，表明部分合并关联反映了组间分离。探索性ROC AUC对于CRP、白细胞计数和局部区域评分为1.000，对于ESR为0.948；这些值是在同一选定队列中推导和评估的。在校正年龄和性别的单独Firth模型中，CRP、白细胞计数和局部区域评分仍与NPC相关，而ESR则不然（p = 0.200）。
结论： 本研究在这一选定的回顾性队列中发现了显著的组间差异，但并未确立诊断性生物标志物或临床截断值。需要独立的前瞻性评估、标准化采样以及对炎症和肿瘤相关混杂因素更充分的控制。
英文摘要
BACKGROUND: Nasopharyngeal carcinoma (NPC) may be accompanied by systemic inflammatory changes, but routine inflammatory markers are nonspecific and have not been validated as diagnostic tests for NPC.
METHODS: This exploratory retrospective comparison screened 178 adults and included 72 eligible records (36 histopathologically confirmed NPC and 36 histologically confirmed benign adenoid-associated pathology); 106 records were excluded because of incomplete endoscopic or laboratory records (n = 41), hematological malignancy (n = 15), severe hepatic failure (n = 11), or a documented systemic inflammatory condition unrelated to the nasopharyngeal presentation (n = 39). CRP, erythrocyte sedimentation rate (ESR), leukocyte count, selected biochemical variables, and an investigator-derived loco-regional clinical/endoscopic severity score were compared. Prespecified sensitivity analyses included age- and sex-adjusted rank regression, restriction to the overlapping age range (39-52 years), group-stratified correlations, and partial rank correlations adjusted for diagnostic group, age, and sex.
RESULTS: The NPC group was younger than the benign group (38.1 ± 7.6 vs. 56.1 ± 8.3 years; p < 0.001). CRP, ESR, leukocyte count, uric acid, and the loco-regional score were higher in the NPC group (all p < 0.01). The principal differences persisted in the overlapping-age subset (NPC n = 17; benign n = 16; all p < 0.001) and in age- and sex-adjusted rank analyses. Pooled correlations were attenuated or changed after stratification and covariate adjustment, indicating that part of the pooled association reflected between-group separation. Exploratory ROC AUCs were 1.000 for CRP, leukocyte count, and the loco-regional score and 0.948 for ESR; these values were derived and evaluated in the same selected cohort. In separate Firth models adjusted for age and sex, CRP, leukocyte count, and the loco-regional score remained associated with NPC, whereas ESR did not (p = 0.200).
CONCLUSIONS: The study identifies marked between-group differences in this selected retrospective cohort but does not establish diagnostic biomarkers or clinical cut-offs. Independent prospective evaluation, standardized sampling, and fuller control of inflammatory and tumor-related confounding are required.