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目的:分析人类白细胞抗原(HLA)等位基因与鼻咽癌(NPC)患者临床特征的关系,探讨二者对NPC5年生存预后的影响。方法:回顾性总结231例潮汕地区NPC患者的HLA-A、-B等位基因分型并收集其临床特征信息。HLA-A、-B等位基因与NPC患者临床特征的相关性采用二分类Logistic回归分析;用Kaplan-Meier方法进行生存估计,用Cox比例风险模型进行生存分析。结果:Cox单、多因素分析均显示,在临床Ⅲ～Ⅳ期NPC患者中,HLA-A*24携带者的5年生存率明显低于HLA-A*24非携带者(P<0.05,RR=1.710,95%CI=1.052-2.780和P<0.05,RR=1.825,95%CI=1.117-2.981),提示HLA-A*24为NPC的独立预后因素;此外,年龄、抽烟、临床分期,以及T、N、M分期等也都是影响NPC预后的重要因素(P≤0.05);但HLA-A、-B等位基因与NPC患者临床特征并无显著性相关。结论:处于临床Ⅲ～Ⅳ期的NPC患者,HLA-A*24携带者的预后较非携带者要差,临床检测HLA-A*24对判断NPC患者的预后可能会有所帮助。
Objective: To analyze the relationship between human leukocyte antigen (HLA) alleles and the clinical features of patients with nasopharyngeal carcinoma (NPC). Methods: The HLA-A and-B allelic genotypes of 231 patients with NPC in Chaoshan region were retrospectively reviewed and their clinical features were collected. The association of HLA-A and B alleles with the clinical features of NPC patients was analyzed by binary logistic regression analysis. Survival was estimated by Kaplan-Meier method and survival analysis by Cox proportional hazards model. Results: Cox single and multivariate analysis showed that the 5-year survival rate of HLA-A * 24 carriers was significantly lower than that of HLA-A * 24 non-carriers in patients with clinical stage III-IV NPC (P <0.05, RR = 1.710,95% CI = 1.052-2.780 and P <0.05, RR = 1.825,95% CI = 1.117-2.981), suggesting that HLA-A * 24 is an independent prognostic factor for NPC; in addition, age, smoking, clinical stage, As well as T, N and M staging were also important factors affecting the prognosis of NPC (P≤0.05). However, there was no significant correlation between HLA-A and B alleles and the clinical features of NPC. Conclusion: The prognosis of patients with stage Ⅲ-Ⅳ NPC is lower than that of non-carriers in HLA-A * 24 carriers. Clinical detection of HLA-A * 24 may be helpful in judging the prognosis of patients with NPC.