PurposeTo evaluate the prognostic value of circulating tumor cells (CTCs) in nasopharyngeal carcinoma (NPC).MethodsCox’s proportional hazards regression models were used to identify whether CTCs was a poor prognostic factor for NPC. Chi-square tests were used to analyze and compare the distribution characteristics of CTCs in NPC. ROC curve was used to estimate the cut-off point of CTCs. Kaplan-Meier survival analyses were used to observe the prognostic value of CTCs alone and in combined with Epstein-Barr Virus DNA (EBV-DNA).ResultsCTCs was confirmed to be an independent risk factor for poor prognosis of NPC by Cox’s regression models that enrolled 370 NPC cases and took age, gender, EBV-DNA and CTCs as variables. The proportion of CTCs in stage IV NPC was statistically different from that in stage III; the cut-off point of CTCs between stage IV (288 cases) and stage III (70 cases) NPC estimated by ROC curve was 0.5. The prognosis of advanced NPC patients became worse with the increase of CTCs count. The combined detection of CTCs and EBV-DNA could better predict the prognosis of NPC compared with the single detection of EBV-DNA.

中文翻译：

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循环肿瘤细胞：晚期鼻咽癌预后不良的重要标志物

目的评价循环肿瘤细胞（CTCs）在鼻咽癌（NPC）中的预后价值。方法采用Cox比例风险回归模型确定CTCs是否是鼻咽癌的不良预后因素。卡方检验用于分析和比较 NPC 中 CTC 的分布特征。ROC 曲线用于估计 CTC 的截止点。Kaplan-Meier 生存分析用于观察 CTCs 单独和与 Epstein-Barr 病毒 DNA (EBV-DNA) 联合的预后价值。 结果通过 Cox 回归模型证实 CTCs 是 NPC 预后不良的独立危险因素370例NPC病例，以年龄、性别、EBV-DNA和CTCs为变量。IV期NPC中CTCs的比例与III期有统计学差异；通过 ROC 曲线估计的 IV 期（288 例）和 III 期（70 例）NPC 之间 CTC 的截止点为 0.5。随着 CTC 计数的增加，晚期 NPC 患者的预后变得更差。与单独检测EBV-DNA相比，CTCs和EBV-DNA联合检测能更好地预测NPC的预后。