Objective: To compare clinical characteristics between familial nasopharyngeal carcinomas(NPCs) and sporadic NPCs in Guangdong province, China, a high-risk area.Methods: Between 1991 and 2001, 993 NPC patients treated at the Cancer Center of Sun Yat-Sen University in Guangdong were randomly selected as probands. Information about NPC among the probands' relatives and other information were obtained from a retrospective review of the patients' medical records. The patients were divided into sporadic NPC, low-frequency familial NPC(one NPC patient in addition to the proband in three generations), and high-frequency familial NPC(2 or more additional NPC patients in three generations) groups. Pathological and clinical characteristics were compared among these groups.Results: Of the 993 patients, 131(13.2%) had a familial history of NPC. The average age at diagnosis was the lowest in the high-frequency familial NPC group(39 years; P=0.048). Although the overall survival(OS), distant metastasis-free survival(DMFS), and disease-free survival(DFS) rates did not differ between familial and sporadic NPCs, the locoregional recurrence-free survival(LRFS) rate increased in the order sporadic NPCs, low-frequency familial NPCs, and high-frequency familial NPCs(P=0.009), with 5-year rates of 70%, 83%, and 87%, respectively. Multivariate analysis showed that family history of NPC was an independent favorable prognostic factor for LRFS, with adjusted hazard ratio(a HR) of 0.548, 95% CI(0.342-0.878). The high LRFS for familial NPCs was mainly noted among young, advanced-stage patients who received continuous radiation treatment.Conclusions: Genetic factors may play an important role in the etiology of high-frequency familial NPC and underlie the early age of onset and sensitivity to radiotherapy.
背景与目的:肥胖和低体重与多种肿瘤的进展及预后相关。本研究探讨体重指数(body mass index,BMI)对鼻咽癌患者预后的影响,为判断鼻咽癌患者的预后提供参考。方法:从1990-2003年在中山大学肿瘤防治中心确诊为鼻咽癌的病例中随机抽取1489例,按照患者的BMI分为正常、低体重、超重和肥胖4组。采用生存分析对4组患者的预后进行综合比较分析。结果:低体重组、超重组和肥胖组患者的年龄、T分期、N分期和总分期与正常体重组相比其差异均有统计学意义(P<0.0001)。以低体重组为对照组,正常组、超重组和肥胖组的总生存率、无复发生存率和无转移生存率的相对危险度均小于1,并且随着体重的增加相对危险度逐渐降低。单因素生存分析结果显示,低体重组总生存率、无复发生存率和无转移生存率低于正常体重组和超重组、肥胖组(P<0.0001);多因素分析结果表显示,年龄、T分期、N分期和BMI分级均可作为显著的独立预后因素(P<0.05)。结论:治疗前低BMI鼻咽癌患者的总生存率、无复发生存率、无转移生存率较正常BMI患者下降。治疗前BMI可作为评价鼻咽癌患者预后的一个重要参考指标。
